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Gopjiiglit^ 



COPYRIGHT DEPOSIT 



A Doctor's Viewpoint 

By 

John Bessner Huber, A. ML, M. D. 



Editor, The Dietetic and Hygienic 
Gazette ; Author, Consumption 
and Civilization ( Lippincott's ) ; 
Fellow of the American Medical 
Association and of the New York 
Academy of Medicine, Etc., Etc. 



GAZETTE PUBLISHING COMPANY 
87 NASSAU STREET, NEW YORK 






Copyright, 1914, by 
John B. Huber 



JUL 

©CIA379518 



TABLE OF CONTENTS 

A Twentieth Century Epic 9 

The Elimination of Tuberculosis 32 

Danger Signals . 41 

The Prevention of Cancer 51 

Don't Be a Hermit Crab 59 

The Cowardice of Brave Men 67 

Woman's Seven Ages 76 

Let Us Go Out Into the Sunshine 91 

Sense Training 98 

Eugenics 103 

Medical Research and Education 110 

Editorial Effusions 124 

How Genius Manifests Itself 124 

The Humanness of Scientists 125 

Pulicide 128 

Unscientific Futilities 131 

Cupid in Psychology 133 

Social Excitements 134 

Psychic Research 138 

Factors of Safety 140 

Killing and Conservation 142 

The Ethnics of Infection 144 

Consumption and Civilization 147 

Mongrelized Races 151 

An Anti- Vivisection Play 153 

Spugs and Spefs 156 

Euthanasia 157 

The Philosophy of Prayer 160 



To 
L. M. H. 

Would it were worthier ! 



PREFATORY NOTE 

A short preface; since nobody ever reads a long 
one. Much of our interest in life lies in how we ap- 
preciate one another's ways of looking at it — the way 
of the counsellor, the sky-pilot, the painter, the farmer, 
the policeman on the fixed post, the steeplejack, the 
man on the street, the woman in the wrapper. If this 
book gets carried in anybody's coat pocket, or se- 
cures place under the evening lamp and besides 
the armchair it will be because it has been written 
from a doctor's viewpoint of our human relations and 
of our civilization. 

Some of the matter in the following pages has ap- 
peared in The American Review of Reviews, Collier's 
Weekly, Harper's Weekly, The New York Evening 
Post, Outdoor Life and Recreation, Knowledge, Scien- 
tific American, Lippincott's Magazine, The British 
Journal of Tuberculosis and other Journals. To the 
editors of these publications I make my grateful ac- 
knowledgments . 



A TWENTIETH CENTURY EPIC 

Venerable folk can to-day recall how in their child- 
hood the medieval conception of disease still persisted 
— that the forces evolving pestilence were mightier 
than man could hope to struggle with, too awful to be 
defied; the only escape for humankind lay in propi- 
tiating, if possible, those supernatural powers. Hosts 
must succumb when the angel of death spread his wings 
on the blast, a cloud passed over a doomed city and 
from it a retributive hand scattered upon an evil gen- 
eration the seeds of destruction. 

Such images permeated literature and made it mag- 
nificent. The poetic temperament may a little regret 
the extent to which the modern science of preventive 
medicine has damaged imaginative literature, so that 
such sublime pictures as Milton portrayed, such su- 
perb visions as Byron and Coleridge saw, cannot now 
get themselves expressed; and (since human interest 
depends largely on the extent to which events imagined 
may conceivably enter into human experience) would 
be little appreciated if they were published. We could 
not to-day enjoy, in quite the same way, another 
"Masque of the Red Death," in which the bubonic 
plague was personified ; nor another such work as "The 
Wandering Jew," who personified the cholera that 
stalked spectre-like through three continents. 

The modern idea of warfare against disease was ex- 
pressed by Pasteur: "It is within human power to 
banish all parasitic (infectious) diseases from the face 

9 



10 A DOCTOR'S VIEWPOINT 

of the earth." Here surely is a more reverent con- 
ception than that medieval one; for it does not hold 
diseases to be scourges inflicted by a cruel deity. And 
it is a juster conception, for it holds most pestilence 
to be practically man-made ; wherefore, and by the same 
token, such pestilences are man-preventable. And we 
are concluding that man, not God, fixes the death rate. 
Here, as elsewhere in life, it is for man to work out his 
own salvation. Nor does the modern Prometheus defy 
divinity; but seeks, how successfully we shall see, by 
the exercise of his God-given faculties, to free his race 
of aeon-long sufferings and disasters. Morse's first tele- 
gram read : "What hath God wrought." We are now 
to consider what God hath wrought through human 
agency. 

PREVENTIVE MEDICINE 

Our modern epic begins, then, with the birth of pre- 
ventive medicine, now the most pervasively benignant 
force in civilization. Pasteur was the accoucheur when 
he demonstrated microscopic parasites (germs, bacte- 
ria, bacilli) to be the essential causes of the infections ; 
each infection having its specific and invariable germ. 
And let us premise here that, in science at least, great 
names are landmarks; and the owners of these names 
have traversed and gleaned in fields where many a de- 
voted and forgotten laborer had delved and sown and 
pathetically sweated blood in his altruistic zeal. In 
science at least no man works in vain. Full many an 
one, worthy of an elegy, has given his whole life to 
establishing a fact or indeed only an item to a fact; 
his work unrealized, ridicule and even persecution often- 
times his only compensation, throughout perhaps in 
the meanest destitution; yet his life and his work have 
been absolutely essential to the building of a mighty 



A TWENTIETH CENTURY EPIC 11 

fabric. Martyrs have been many among such, dying 
of the diseases from which they sought to defend others ; 
knowing too, full well, what their own fate would be. 
Nor does it in any wise detract from the gratitude due 
the great man, that he has profited by the labors of 
others, adding what he can of his own, scrutinizing 
every detail, every datum, permeating and illuminating 
all with his own genius, cementing the mass with his 
own deductions. Thus did Jenner's inoculations, for 
example, make clear the way for Davaine and Lister, 
Tyndall and Pasteur. 

Upon the foundation then, thus laid by Pasteur, 
did Koch and his co-workers bring to maturity the 
science of preventive medicine. And what phase of hu- 
man existence does it not to-day influence? Personal, 
domestic, school, communal hygiene, as we now under- 
stand these terms, are derived from it. Infants no 
longer die by dispensations of Providence, but by germ- 
laden milk. Preventive medicine has become adequately 
equipped to deal with housing, sewage, filtration — well- 
nigh all problems of rural, civic, State, national, inter- 
national, world sanitation. Vast tracts of hitherto pes- 
tilent land, formerly impossible of human habitation, 
are now made salubrious and capable of most profitable 
agriculture. Only Oriental fatalism stands in the way 
of eliminating those age-long plagues, which are still 
nurtured in the bosom of Old Mother India, and go 
forth on their ghastly business from that dreadful 
progenitor. But now with ever-decreasing frequency 
and virulence; for Ross, Manson, Haffkine, and Shiga 
and their confreres have been and are making tremen- 
dous progress in their titanic work against those in- 
fections. Africa's most dreadful infection, the sleeping 
sickness, is also being mastered, largely through the 



12 A DOCTOR'S VIEWPOINT 

work of Koch, Ehrlich, and their colleagues. Malaria, 
that tyrant which only a score of years ago dominated 
half the world, is now suffered only by the supine. 

Tuberculosis, which since the beginning of the race 
has been the Captain of the Men of Death, can also, 
if we but will, be eliminated from human experience. 
In commerce, more than in any other phase of civiliza- 
tion, has advantage been taken of the benefits preven- 
tive medicine can bestow: such infections as yellow 
fever, smallpox, malaria, typhoid and the dysenteries 
have been abolished from many entrepots: business in- 
deed, because it has been found to pay, has succeeded 
not infrequently, where discouraged humanity has failed. 

And the wisest statesmanship is now comprehending 
that through preventive medicine disease can be abol- 
ished, life prolonged, and existence made happier. How 
sanely has Lecky observed: "The great work of sani- 
tary reform has been perhaps the noblest legislative 
achievement of our age, and, if measured by the suffer- 
ing it has diminished, has probably done more for the 
real happiness of mankind than all the many questions 
that make and unmake ministries." And Dr. Eliot, of 
Harvard, is insisting that no religion is worthy the name 
which does not take to its grateful embrace preventive 
medicine. 

A MOST SALUTARY INVASION 

As early as 1847 the idea existed that mosquitoes 
have somehow to do with the spread of yellow fever. 
In 1881 Dr. Carlos F. Finlay, of Havana, definitely 
set forth the theory, which he tried to prove but could 
not because he used in his inoculation experiments mos- 
quitoes that had bitten yellow fever patients only within 
five days; whereas it was later demonstrated that the 



A TWENTIETH CENTURY EPIC 13 

mosquito is harmless until twelve days or longer after 
the biting. 

When our army occupied Cuba, in 1898, Yellow Jack 
had been epidemic, indeed practically endemic (that is, 
constant) in Havana; and despite all the then-known 
methods of fighting that infection there were about 1,500 
cases and 231 deaths among American officers and men 
in the year 1900. Dr. George M. Sternberg, Surgeon- 
General of the United States Army, appointed four 
surgeons who were then on duty in Cuba, Walter Reed, 
James Carroll, Jesse W. Lazear, and Aristides Agra- 
monte, a board to test the theory of mosquito trans- 
mission. Realizing that human life must be put in 
jeopardy, these men were unwilling to assume the re- 
sponsibility of asking others to risk death; and they 
agreed to make the first experiments upon themselves. 
(This was, by the way, after Dr. John Guiteras, of 
Havana, began in February, 1891, a series of tests to 
ascertain whether yellow fever could be propagated in 
a controllable form by means of infected mosquitoes, 
thus securing immunization, as is done by vaccination in 
smallpox. He infected eight volunteers with mosquitoes, 
three of whom died, including an American nurse — (Miss 
Clara D. Maas, of Orange, N. J.). Before the mosqui- 
toes were ready for the tests Reed was ordered to Wash- 
ington on official duty and was prevented from taking 
part in the experiments; and quite rightly he did not 
afterward subject himself to them. Agramonte was an 
immune. Carroll was first bitten and suffered a very 
severe attack of yellow fever, from which he recovered, 
though for a long time his life was despaired of. And 
his premature death was certainly hastened by this ex- 
perience. Next Lazear, while in a yellow-fever hos- 
pital, collecting blood from the patients for study, saw 



14 A DOCTOR'S VIEWPOINT 

a mosquito settling on the back of his hand. Like the 
ancient Roman who thrust his hand in the devouring 
flame, he calmly let the insert remain there till it had 
satisfied its hunger and had injected the lethal poison. 
Lethal? Yes, for five days later this hero of the ages 
came down with yellow fever and died of it. 

HEROIC VOLUNTEERS IN THE WAR AGAINST DISEASE 

To establish the length of the period when an infected 
mosquito became harmful after its biting of a yellow- 
fever sufferer, and also the time which must elapse after 
the patient had been stricken before the disease can be 
conveyed to the mosquito for transmission, Dr. Reed 
instituted a second series of experiments in "Lazear 
Camp" near Quemados, Cuba. General Leonard Wood, 
then military governor of Cuba, gave all possible assist- 
ance, and to encourage volunteers for the tests offered 
a reward of two hundred dollars. And, though his call 
was issued after Lazear's martyrdom and when the army 
realized full well in what manner he and Carroll had 
suffered, "to the everlasting glory of the American 
soldier, volunteers from the army offered themselves 
for experiment in plenty and with the utmost fear- 
lessness." 

The first to present themselves were two young Ohio 
soldiers, John R. Kissinger and John J. Moran; but 
only on the condition that they should receive no pe- 
cuniary reward. Kissinger on three successive occa- 
sions was taken, clad only in a nightshirt, into a room 
where infected mosquitoes were confined and lay there 
quietly until they bit him ; and he was infected with the 
fever, from which he recovered. Moran, similarly clad, 
entered the room containing the mosquitoes, where he 
lay for thirty minutes. Within two minutes from his 



A TWENTIETH CENTURY EPIC 15 

entrance he was being bitten about the face and hands. 
On Christmas morning he was also stricken with yellow 
fever, and, like Kissinger, fortunately recovered. There 
were in all twenty-two, thirteen of them American sol- 
diers, who submitted gloriously to the tests. 

Into the tests to demonstrate that yellow fever was 
not conveyed through fomites (contact infection 
through inanimate objects, contagion) seven persons 
entered — Dr. Robert P. Cooke, an acting assistant sur- 
geon of the army and six privates of the hospital corps. 
In a single room, fourteen by twenty feet, carefully 
guarded against the entrance of mosquitoes, its temper- 
ature maintained at about seventy-six degrees, with a 
sufficient amount of humidity, supplied with a large 
quantity of bed clothing and wearing apparel, taken 
from the beds and persons of patients who died of 
yellow fever, Dr. Cooke and his men slept for twenty 
consecutive nights, handling and wearing the contami- 
nated clothing, "although the stench was almost un- 
bearable." They came out of the ordeal in perfect 
health, proving beyond the possibility of dispute that 
the disease was not contagious and that the mosquito 
is the sole method of transmission. 

"yellow jack" vanquished 

By such heroisms was it demonstrated that: The 
mosquito known as stegomyia, and only that insect, 
serves as the intermediate host for the parasite of yellow 
fever ; this disease is transmitted to the non-immune in- 
dividual by means of the bite of stegomyia that has 
previously fed on the blood of one sick of this disease; 
an interval of twelve days or more after contamination 
is necessary before stegomyia can convey the infection ; 
the period of incubation (from the bite to the appear- 



16 A DOCTOR'S VIEWPOINT 

ance of symptoms) in yellow fever varies from forty-one 
hours to six days; yellow fever is not conveyed by fo- 
mites, wherefore disinfection of articles of clothing, bed- 
ding, or merchandise, supposedly contaminated by con- 
tact with those sick of this disease, is unnecessary. A 
house is infected with yellow fever only when there are 
present within its walls contaminated stegomyia capable 
of conveying the parasite of this disease ; and while the 
mode of propagation of yellow fever has now been def- 
initely determined its specific cause, like the specific 
cause of smallpox, remains to be demonstrated. 

In February of 1901, by order of General Wood, 
Surgeon-Major William Crawford Gorgas, then chief 
sanitary officer of the city, proceeded to eliminate yel- 
low fever from human experience in Havana; and this 
he did within a year, although in at least one hundred 
and fifty years that city had never been free of Yellow 
Jack. He screened cases of yellow fever, and all sus- 
pected cases ; destroyed infected insects ; and suppressed 
stegomyia through control of their breeding places. 
Later he turned the same trick in Panama, whilst White 
banished yellow fever from New Orleans in 1905, 
Liceaga from Vera Cruz, and Oswaldo Cruz from Rio 
de Janeiro in 1909. 

PANAMA BEFORE 1900 

Properly to appreciate what Gorgas and his asso- 
ciates in preventive medicine have done in the Canal 
Zone one must consider what Panamanian conditions 
were before the twentieth century. It was one of Keats' 
finest inspirations — surprised Balboa viewing the Pa- 
cific from a peak in Darien. Balboa is said to have 
contemplated a waterway connecting the two vast 
oceans; and his Spanish sovereign is historied to have 



A TWENTIETH CENTURY EPIC 17 

entertained the scheme, proposed in 1520 by one Angel 
Saavadra. A decade later Balboa's father-in-law, Pedro 
d'Avila, founded Panama, which some now claim to be 
the oldest American city ; not quite correctly, it seems, 
for d'Avila's stronghold was several miles from the pres- 
ent site. In the seventeenth and eighteenth centuries 
Panama was Spain's gateway, through which passed 
most of the gold and silver after Pizarro's conquest of 
the Incas; to which were added also pearls from the 
Islands, gold from Darien and the coast of Central 
America and from Mexico. Panama in those days ri- 
valed the mother country in her splendors. It was a 
life of almost Asiatic luxury. We shall have a word to 
say of peculation under the French occupation, but 
the spirit of "graft" was considerably pervasive in that 
olden time. For instance, the walls of that key to the 
Pacific, of that "gateway to the universe" alone cost 
over $11,000,000 ; and that at a time when labor, mostly 
by enslaved Indians, was indeed dirt cheap. Philip II 
is said to have gazed westward from his palace window, 
shielding his eyes and observing that he was looking 
for the walls of Panama; for "they have cost enough 
to be seen even from here." 

Well, Morgan and his buccaneers and freebooters 
found Panama too rich a prize to disregard; and they 
did for d'Avila's settlement in 1671. Those were the 
days of which Robert Louis and James Pyle have so 
uncannily told; when Yellow Jack was the undertaker- 
in-chief and Davy Jones' locker the graveyard; when 

"Ten men sat on a dead man's chest, 
Ho, ho, ho and a bottle of rum !" 

Old Morgan did the job so well that no vestige of 



18 A DOCTOR'S VIEWPOINT 

Panama was left; its site until the French occupation 
was overgrown by a dense and most pestilent tropical 
forest. Up to the American occupation this neck of 
land binding together two continents has been made 
up of mountains and the valleys between them; dense, 
almost impenetrable undergrowth, making a veritable 
jungle; independent and conjoined bodies of stagnant 
waters; swamp areas; bottomless quagmires, with tor- 
rential river streams draining in the persistent rainy 
seasons the mountain watersheds and deluging the low- 
lands on their way to the Pacific and the Mexican Gulf. 
Humboldt, a century ago, after a visit to the Isthmus 
in which he studied the conditions, gave his belief that 
Panama must always be cursed by yellow fever and ma- 
laria; the former he understood to be caused by the 
decaying mollusks and marine plants on the beach at 
low tide, the latter by foul emanations from over-rank 
vegetation ; then came the French headed by the grandi- 
ose De Lesseps, who squandered from 1881 to 1892 an 
equivalent of more than one dollar for every minute 
of time that has elapsed since Balboa first, in 1513, set 
foot on that wonderful and gruesomely fascinating 
Isthmus. 

A reason why Panama has been peculiarly pestilent is 
that, since Balboa, the Isthmus has been the point of 
crossing between the two oceans in the western hem- 
isphere; wherefore there have always been at Panama 
many unacclimated Europeans, who were easy victims 
to the tropical infections. Gorgas believes that on the 
average, through four hundred years past, there have 
been more unacclimated Europeans in Panama than in 
any other tropical city liable to yellow fever. Where- 
fore this region had acquired the reputation of being 
the unhealthiest known. 



A TWENTIETH CENTURY EPIC 19 

Froude, who visited the West Indies in 1885, wrote: 
"In all the world there is not, perhaps, now con- 
centrated in any single spot so much swindling and 
villainy, so much foul disease, such a hideous dung 
heap of moral and physical abomination, as in the scene 
of this far-famed undertaking of nineteenth century 
engineering. . . . The scene of operations is a 
damp, tropical jungle, intensely hot, wet, feverish, 
swarming with mosquitoes, snakes, alligators, scorpions, 
and centipedes, the home, even as nature made it, of 
yellow fever, typhus, and dysentery ; and now made im- 
measurably more deadly by the multitudes of people 
who crowd thither." 

Except to note that De Lesseps spent $260,000,000 
and had, for all that, done but a fraction of the work, 
we can touch here only on the medical aspects of that 
Gallic debacle ; the suffering and dying were a veritable 
replica of the Black Death of the Middle Ages. Behind 
everything lurked always the grim spectre. "Eat, drink 
and be merry for to-morrow you die" was everywhere 
the ghastly sentiment, either subconsciously felt or 
openly expressed. The strongest to-day would be 
among the buried to-morrow. Y ellow Jack claimed two 
out of four, perhaps two of every three victims among 
those Frenchmen; and how brave they were, how reck- 
less of death ! An instance among many : Claude Mal- 
let, the then consul at Panama, accompanied a surveying 
party of twenty-two to the Upper Chagres. Within a 
a week all but Mallet and a Russian engineer, Dziem- 
bowski were incapacitated by disease. This Russian 
asked Mallet to advance him money, against next pay 
day, for a new suit of clothes. On the afternoon of 
their return the clothing was bought ; and Dziembowski 
accepted Mallet's invitation to lunch the next day. But 



20 A DOCTOR'S VIEWPOINT 

the guest did not come — having died of yellow fever at 
three that morning and having been buried about day- 
light in those clothes. 

Jules Dingier, the first director-general of the canal 
work, had erected for him a $150,000 residence; "La 
Folie Dingier," it was called, because of its excessive 
cost and its rather inaccessible location, high on the 
southern slope of Ancon Hill. Before Dingier could 
occupy his house his wife, son, and daughter died of 
yellow fever; and he returned to France soon after, 
himself to die, a broken-hearted man. Leon Boyer suc- 
ceeded him and had hardly begun his duties when he 
also was smitten and died. "The mysterious malady," 
wrote Bunau-Varilla, a division engineer, "defied all pre- 
cautions, laughed at all remedies, and all that the most 
expert physicians could do for its victims was to ad- 
minister palliatives, the effect of which was moral rather 
than curative." 

Yet the French did as well as could have been done, 
considering that the discovery of the mosquito trans- 
mission of yellow fever disease had not yet been made, 
whilst the Americans came to the Isthmus in the full 
knowledge of these two discoveries. The French had 
admirable hospitals which they ignorantly furnished 
with the means of spreading rather than of checking 
disease. For, in order that their patients might not 
be annoyed by the ants ubiquitous on the Isthmus, they 
placed the posts of the hospital bedsteads in bowls of 
water. In these bowls, then, the death-conveying steg- 
omyia were bred ; whilst no screens were put in the win- 
dows and doors of hospitals and other buildings, thus 
permitting the entrance of the malaria-disseminating 
anopheles mosquito. 



A TWENTIETH CENTURY EPIC 21 

GORGAS IN PANAMA 

Such, then, were conditions in the Canal Zone before 
the Americans took possession. Its sanitary affairs 
were then put in the hands of Colonel Gorgas, who had 
so brilliantly applied preventive medicine in Havana. 
The then military governor of the Zone, Colonel Charles 
E. Magoon, assured Gorgas that all the government's 
resources in that region were at his service. Whereupon 
the cities of Panama and Colon were renovated, house 
by house; sewage systems were installed; the towns 
of the Zone were divided into districts for mosquito 
extermination; buildings were rat-proofed, to guard 
against the bubonic plague; medical inspectors began 
making daily house-to-house canvasses and to report 
suspected cases — all of which latter were at once, willy- 
nilly, segregated in hospitals; all potable waters were 
examined and foods inspected weekly, to guard especial- 
ly against typhoid, the principal ingestion infection; 
the "typhoid fly" was suppressed. 

The result? Gorgas and his associates have made 
this region as infection-free as any in these United 
States, and much more salubrious than a great many. 
Panama now rivals Palm Beach as a health resort. 
Yellow Jack has been absolutely banished from the Zone 
since 1906. During 1907 Gorgas did not have a single 
case of bubonic plague to deal with ; he had 50 per cent, 
reduction from 1906 in malaria, typhoid, dysentery, 
pneumonia, and other grave diseases. His death rate 
was more than 30 per cent, lower in 1907 than in 1906. 
In the region over which he has had jurisdiction (the 
Canal Zone and the cities of Panama and Colon — a 
territory of 448 square miles, extending five miles on 
either side the canal route), he has had in his keeping 
the health of many thousands of men from widely dif- 



22 A DOCTOR'S VIEWPOINT 

ferent parts of the earth, engaged in digging through 
the swamp land of the erstwhile deadliest region in 
existence. In March, 1907, he had 36,000 employees 
under observation, with 122 deaths ; in March of 1908 
he supervised 43,000 men, with only 45 deaths. The 
mortality rate of the Canal Zone for March of that 
year was less than that of the City of New York, which- 
is among the lowest, rural or urban, in civilization. 
During 1906-7 he had 1,273 deaths among 32,314 em- 
ployees ; during 1912-3 he had 483 deaths among 54,000 
employees. 

The French, with an average force of 10,000 men, 
lost during their construction period 22,000 ; the Amer- 
icans, with an average force of 33,000 during about the 
same length of time, had 4,000 die. 

In modern warfare, by the way, it costs about $15,000' 
to kill a man. In the Boer row this item came as high 
as $40,000. The Balkan mix-up with Turkey was con- 
ducted more reasonably — $10,000 burned up in making 
one man food for powder. Gorgas, in the Canal Zone, 
has been saving human life at the actual cost of $2.43 
the individual. Sanitation in the Isthmus under Gorgas 
has cost just five per cent, of the total canal building 1 
expenditures. 

When, then, the Panama Canal is open to the world's 
vessels let no one have to be reminded that this epic 
work could never have been accomplished had not de- 
voted and zealous men, from Finlay to Gorgas, so mag- 
nificently, and with so much altruism, suffering and 
martyrdom led up to and applied the discoveries and 
resources of medical science to the colossal enterprise. 

GORGAS AND MALABIA 

And what Gorgas did against malaria in the Isthmus 



A TWENTIETH CENTURY EPIC 23 

and elsewhere deserves a section by itself. It is more 
difficult to cope wtih malaria than with yellow fever, 
although the latter is far the more fatal disease; be- 
cause stegomyia breeds about human dwellings, whilst 
anopheles loves to roam afield and in rural waterways. 
Wherefore, to sketch the anti-malarial work were, as 
honest Cassio might observe, even a more excellent song 
than the other. 

And the consideration is of universal importance, 
because the climatic and geographical conditions for the 
breeding of anopheles are ideal in the tropics all the 
year around. It was Ronald Reed, an English Army 
surgeon, who discovered in 1898 that the malarial germ, 
the plasmodium (which Laveran had demonstrated) is 
conveyed to man only by the bite of this particular 
species of mosquito. Nowhere else on the globe could 
The Lady Anopheline, who alone transfers the plasmo- 
dium (being here, as elsewhere in the cosmos, deadlier 
than the male) flourish so luxuriantly as in Panama, 
were not its breeding frustrated by sanitary science ade- 
quately applied. When malaria, then, can be practi- 
cally extinguished from the Isthmus, the like can be 
achieved pretty much anywhere else, if the inhabitants 
of the given region have but the acumen and the back- 
bone to go about the work. Here, then, is Gorgas 5 
scheme : 

1. The habitat of anopheles during the larval stage 
is destroyed within a hundred yards of dwellings. The 
larvae of this mosquito live only as a rule in clear, fresh 
water that is plentifully supplied with grass and algae. 
Drains are the most effective and economical plan ; once 
put down they require no more attention ; no water being 
exposed to the surface, there is no breeding place left 
for the mosquitoes; by means of a horse-mower or 



24 A DOCTOR'S VIEWPOINT 

scythe the grass over the drain can be cut. Failing 
tiles, an open concreted ditch may be put down; but 
the first cost here is nearly as much as for tiling, and 
the concrete ditch must constantly be kept cleared of 
obstructions in which breeding pools may be formed. 
Open ditches are the least effective and most expensive. 
2. All protection for the adult mosquito must be de- 
stroyed. The adult is weak on the wing, not generally 
flying far and needing plenty of grass and brush for 
protection against the wind. Brush and grass are 
therefore cleared for a hundred yards around dwellings ; 
where the locality is to be occupied for a year or more 
it is best graded and grassed, the latter kept well mowed. 
There is no objection to a little shrubbery or a few 
trees about a dwelling. 3. All habitations are 
screened, but effectively. Screens as ordinarily put up, 
without expert supervision, are of little use. Good 
wire should last three years ; there is plenty of screen- 
ing on the market that will not last six months. 4. 
Where breeding places cannot be destroyed by draining, 
larvse are destroyed by means of crude petroleum, 
Phinotas oil, and sulphate of copper. The first of these 
is used in temporary pools, caused by bad construc- 
tion, or at temporary camps where it would not be 
economical to drain, and wherever drainage is imprac- 
ticable ; the last two are used for killing the larvae in 
the algas and grass along the edge of a lake, a stream 
or a swamp. 

For those interested in the health of industrial camps, 
Gorgas makes exceedingly pregnant observations: In 
and about the Canal Zone 50,000 laborers and their 
families have been scattered over 500 square miles, 
though they have been collected principally in some 
fort} 7 camps or villages along the line of the canal; 



A TWENTIETH CENTURY EPIC 25 

these 500 square miles are divided into seventeen dis- 
tricts, all under a chief sanitary inspector with the 
necessary clerical force and three assistants, of whom 
one is especially wise in mosquito lore; the second ex- 
pert in ditching, draining, oiling, etc. ; the third a com- 
petent executive. Each one of the seventeen districts 
has had its district inspector, who has had from forty 
to fifty laborers to do the necessary draining; car- 
penters to keep the screens in repair; and one or two 
quinine dispensers, who go about urging, though not 
compelling, employees to take three-grain pills as 
prophylactic doses. The district inspector has re- 
ported daily to the central office the number of ma- 
laria cases and the number of employees among whom 
the patients live. Each inspector has been held re- 
sponsible for any excess malaria in his district. If 
the admission rate for malaria during the week has 
risen above one and a half per cent, something is con- 
sidered wrong, and the assistants to the chief sanitary 
inspector are sent to discover the cause. These as- 
sistants have, moreover, been kept constantly busy 
over the work, advising and instrucing the district in- 
spectors. Herein Gorgas has found the gist of the 
whole situation : the district inspector and the working 
force, having usually no special knowledge of mosquito 
life and habits, have had to be constantly under the 
surveillance and supreme control of the sanitary officer 
and his trained scientific assistants, who have then been 
held responsible. 

GORGAS TO THE WITWATERSRAND 

The Chamber of Mines of Johannesburg invited 
Colonel Gorgas to visit South Africa and to study 
the sanitary conditions in the Witwatersrand mines. 
We may be sure that as a result there will be length 



26 A DOCTOR'S VIEWPOINT 

of days for many a poor Kaffir, who will otherwise 
have died untimely and most pathetically. Colonel 
Gorgas has gone with the consent and approval of 
our War Department. The workers in the Rand gold 
mines are reported to be dying off in great numbers 
of pneumonia, epidemics of which infection have been 
rapidly succeeding one another. And the invitation 
came because Colonel Gorgas has solved in Panama 
most beneficently this problem of pneumonia preven- 
tion, along with the others we have considered. 

As in the Canal Zone, Gorgas believes that the pneu- 
monia conditions are part of the grippe problem, be- 
cause almost all cases of the former follow upon attacks 
of the grippe. People all over the world might profit- 
ably consider this. Grippe and pneumonia, like the 
other diseases we have dwelt on, can be abolished if the 
people concerned but choose; nor, as we have seen, 
would the cost be beyond the resourcs of any com- 
munity, state or nation. With regard to grippe there 
is the erroneous impression that it is too trivial a mat- 
ter to bother about. Well, the Dutch have put up a 
proverb in the house where Peter the Great studied 
shipbuilding: "Den Grooten Man is niets te klein" — 
to the great man there is nothing too trivial; and that 
is why the world may be confident that Gorgas will 
clean up that pneumonia job in the Rand and the 
grippe job along with it. 

THE "KILL" IN GUAYAQUIL 

Consider, by way of contrast, the graphic presenta- 
tion of fourteenth-century conditions in a twentieth- 
century town made, under the above caption, by The 
South American of February 1, 1914. Guayaquil, 
Ecuador's principal seaport, is one of the unhealthiest 



A TWENTIETH CENTURY EPIC 27 

spots ill the world. "It has a first mortgage on most 
of the malarial fevers in existence and yellow fever 
might almost be said to be an industry." Occasionally 
efforts, more gruesomely diverting than effective, have 
been made to fight infection. For example, at a time 
when there were a score of yellow fever cases in the 
Guayaquil hospital and the community was literally 
germ saturated, the local health authorities refused a 
party from the North desiring to go to Quito, permis- 
sion to land on the ground that some of its members 
might bring in that disease. And many Northern 
papers were deceived to the extent that they praised 
the effective measures taken in Guayaquil. Again, there 
was an absurd plan providing for a large quantity of 
drain pipes to carry off the excessive rainfall; this, it 
seems, was because somebody had an option on a supply 
of pipe. 

The bubonic plague appearing in Guayaquil, Dr. 
Lloyd, the American Marine Hospital physician, then 
on duty in that place, was employed by the municipal- 
ity. But as the epidemic, by reason of his zeal, grad- 
ually lessened and cases became sporadic, the port 
"again became normal in its unhealthiness and one 
more disease, and that the deadliest, was added to the 
list." 

But there is now hope of Guayaquil, because the 
rigid quarantine maintained at Panama by Gorgas is 
setting a standard which no other community, certainly 
none on the Mexican Gulf or the Caribbean Sea, can 
ignore. For no vessels coming from such ports or 
having touched there would be permitted to enter the 
Canal without exhaustive scrutiny and unendurable 
delay. 

During two years past our own Government has been 



28 A DOCTOR'S VIEWPOINT 

quietly persuading the Ecuadorean Government to clear 
up the Guayaquil situation. And at the request of the 
latter, Gorgas, heading a commission of experts, vis- 
ited Guayaquil, made a thorough scientific investigation 
of conditions, and submitted an elaborate report, which 
expressed no doubt as to the ability of real live, con- 
scientious men to establish and maintain a clean, healthy 
port. The cost would be some $12,500,000, about half 
the total commerce of Ecuador, approximately 90 per 
cent., of which passes through Guayaquil. Not pro- 
hibitive, obviously. 

FROM "LITTLE REBEL" TO SURGEON-GENERAL 

There is a fine "billboard" displayed in the metrop- 
olis intended for the wholesome influence of our youth. 
The ascending steps in the career of General @rant 
from the hardest conditions in life to the Presidency 
are presented, underneath all being the legend : "What 
will be your career with much better chances in your 
favor?" Colonel Gorgas, in an address delivered in 
June, 1912, at the commencement exercises of Johns 
Hopkins University, in Baltimore, said : 

"I am bound to the Baltimore of a former generation 
by the closest ties of gratitude and friendship. I first 
came to Baltimore about forty-five years ago — a rag- 
ged, barefoot little rebel, with empty pockets and still 
more empty stomach. My father had gone south with 
Lee's army. At the fall and destruction of Richmond, 
my mother's house, with all that she had, was burned, 
leaving her stranded with six small children. She 
came to Baltimore and was there assisted and cared for 
by friends. These memories are vivid with me and can 
never be effaced." How beautifully rounded out, then, 
was this "human document," when Johns Hopkins gave 



A TWENTIETH CENTURY EPIC 29 

to Colonel Gorgas its honorary degree of doctor of 
laws. In conferring this Dr. Wm. H. Welch extolled 
Gorgas 5 signal service to his profession, to his coun- 
try, and to the world by his conquests of pestilential 
diseases. "With high administrative capacity and with 
full command of the resources of sanitary science Colo- 
nel Gorgas has given to the world the most complete 
and impressive demonstration in medical history of the 
accuracy and life-saving power of a knowledge con- 
cerning the causation and mode of spread of certain 
dreaded epidemic and endemic diseases. He it is who, 
in spite of obstacles and embarrassments, has made 
the construction of the isthmian canal possible with- 
out serious loss of life or incapacity from disease — 
a triumph of preventive medicine not surpassed in im- 
portance and significance, in the conquest of science 
over disease, in the saving of untold thousands of hu- 
man lives and human treasure, in the protection of our 
shores from the once ever-threatening scourge of yellow 
fever, in the reclamation to civilization of tropical lands 
— in results such as these are to be found the monu- 
ments of our laureate, his victories of peace, to which 
this university now pays tribute by such honor as it 
can bestow." 

Many other just honors, many encomiums from every 
civilized nation, have come to this great benefactor. 
The latest is President Wilson's nomination of Gorgas 
(who had in 1903 been made Colonel by special act of 
Congress in recognition of his distinguished services) 
to be Surgeon-General of the Army of the United 
States, with the rank of Brigadier-General. The Jour- 
nal of the American Medical Association has well ob- 
served : 

'For his masterly ability as an organizer and ad- 



«i 



30 A DOCTOR'S VIEWPOINT 

ministrator, highest praise is due to Colonel Goethals, 
and any reward which Congress or the President may 
see fit to confer on him will be well deserved; but the 
mechanical construction of the Panama Canal differs 
from other engineering feats only in size. The work 
of the Sanitary Department under Colonel Gorgas has 
not only been the greatest task of sanitation that has 
ever been undertaken, but it is also unique and epoch- 
making. For the first time in human history a region 
which, since the earliest traditions of civilization, has 
been regarded as a plague spot in which it was impos- 
sible for civilized man to live and work, has been con- 
verted into a place fitted for enjoyable habitation and 
labor, with a death rate below that of the most mod- 
ern cities." 

The unique value of the work of Colonel Gorgas lies 
in his practical demonstration that regions of the earth 
hitherto closed to the white man can be made as hab- 
itable as any portion of our own country. Any sec- 
tion of the earth can now be made open to civilization. 
Nor can civilized man now recede to his own position 
of fatalism, resignation, or indifference, to the ravages 
of epidemic disease. 

This, then, has been the career of Colonel Gorgas. 
It is characteristic of the man and of both the pro- 
fessions of healing and of soldiery which he so nobly 
represents that no reward in the form of great wealth 
has ever been his, nor would it have ever been con- 
sidered or accepted. The satisfaction of work well done 
for the good of humanity is the modest distinction 
worthy of him and of his monumental work. 

There should, finally, be a Department of Public 
Health in Washington, with a Secretary of Public 
Health in the President's Cabinet. Ninety millions of 



A TWENTIETH CENTURY EPIC 31 

people would be vastly benefited, in the most vital re- 
lations of life, by the appointment, with his acceptance, 
of Brigadier-General Gorgas to this pre-eminence. 



THE ELIMINATION OF TUBERCULOSIS 

My friend and colleague, and noble champion in the 
anti-tuberculosis fight, Dr. Mary E. Lapham, in a fine 
article in the New York Evening Post, quoted from my 
paper in Harper's Weekly that the tubercle bacillus 
is the essential, specific cause of tuberculosis and that, 
if all sorts and conditions of men and women would 
combine to help the doctor in preventing the spread 
of this germ we could eliminate the disease (consump- 
tion) from human experience. I had written also that 
"Tuberculosis is not only a doctor's affair, but is also 
the most tremendous economic and social degeneration 
in existence." Dr. Lapham considered these ideas of 
mine pretty far fetched; so, in extenuation of them, I 
wrote in The Evening Post the following: 

Dr. Lapham and I, however divergent in our ideas of 
getting there, have our eyes on the same goal. The 
tubercle bacillus is indeed the specific cause of tuber- 
culosis; there is no tuberculosis where the germ es- 
sential to the disease does not exist. But there are two 
elements in the evolution of consumption; the specific 
cause, the germ; and the pre-disposition, the state of 
the body by which it becomes a soil for the bacillus. The 
tubercle bacillus (I refer to the human type) cannot 
multiply outside the human body except under labora- 
tory conditions. It is not (in the large aspects we are 
considering) a notable danger to humankind when con- 
tained in human excreta; the danger is mostly from 
human sputum. 

32 



ELIMINATION OF TUBERCULOSIS 33 

CHILDREN RARELY BORN TUBERCULOUS 

I think children are rarely born having the tubercle 
bacillus in their bodies, although all too many of them 
are born with vitiated tissues that are congenial to the 
growth of this germ. That infants and children be- 
come, infected with the bovine tubercle bacillus is well 
recognized, and this situation is now being so conscien- 
tiously coped with that I do not think it need enter 
into the general problem. And I do not believe that 
tuberculosis in the other creatures mentioned by Dr. 
Latham is transmitted to humankind to the degree that 
we need consider it in this relation. In short, the con- 
sumptive's sputum is the main granary of human tuber- 
culosis. And the gist of the matter lies in this: that 
the tubercle bacillus is the index to the fact, the na- 
ture, and the prevalence of the disease. The vital point 
for the layman to grasp, and then to make a part of his 
religion, an article of faith — absolutely undogmatic 
(though my colleague writes of my "dogma"), because 
nothing can conceivably be more demonstrable — that 
the tubercle bacillus can get no implantation in a: 
healthy body; for it the healthy body is stony ground, 
this germ is a miserable saprophyte, depending for its 
subsistence, growth, and multiplying on dead, or devital- 
ized, or sapped tissues. 

That is why tuberculosis is a disease of the poor, of 
the submerged, a disease developed in sunlessness, cold, 
starvation, misery; in the overworked, exhausted, anx- 
ious body (for what is more predisposing, more sap- 
ping, than the anxious mind), and in the body de- 
vitalized by previous or concomitant diseases, of which 
alcoholism is pre-eminent, Wherefor I have ever main- 
tained that doctors, having demonstrated beyond per- 
adventure the causes of tuberculosis and how it can 



34 A DOCTOR'S VIEWPOINT 

be prevented, having clearly shown the way, it is "up 
to" the rest of civilization to work with the doctors in 
the altogether practicable, though epically difficult, 
business of vanquishing once and for all the Captain of 
the Men of Death. 

Why difficult? Here are some reasons why: 

WHERE THE TARIFF COMES IN 

Think of a tariff that put an average tax of 42 per 
cent, on the necessities of life. Consider what Dean 
Henry Wade Rogers has written : "We all know that, 
no matter what may be the profits which come into 
the treasury of a Trust, the wage paid is the prevail- 
ing rate, the market price. The tariff has made the 
"Pittsburg millionaire" and it has also made the Pitts- 
burg laborer. What the latter's condition is the Pitts- 
burg Survey discloses. The consideration shown to 
the workingman is seen in the provisions of the Payne- 
Aldrich Tariff. By that act he is taxed 75 per cent, 
on his woolen suit, 12 per cent, on his shoes, 71 per 
cent, on his stockings and underwear, 50 per cent, on 
his cotton shirt, 78 per cent, on his woolen hat and 
gloves. The dinner pail he carries is taxed 45 per 
cent. The stove in his home and the pots and kettles 
are taxed 45 per cent. The common crockery on his 
table is taxed 55 per cent., his knife and fork 50 per 
cent., and his spoon 45 per cent. The window glass 
in his house is taxed 62 per cent., and there is a tax on 
the lumber or the brick with which the building is con- 
structed, and on the paint and the wall paper used in 
its finishing. The food with which he makes his frugal 
meal is taxed, the sugar he uses being taxed 54 per 
cent." 

We doctors tell the poor that in order to get well 



ELIMINATION OF TUBERCULOSIS 35 

of their consumption they have to eat abundantly of 
pure nutritious food, part of which must be half a 
dozen fresh eggs a day ! What brute has ever been so 
vile as the human being who corners the food market; 
as those selling fowl putrified from storage several years 
back ! Think of millions of eggs being held up for top 
prices while the poor are sold "rots and spots" (rotten 
eggs passed through sieves so that chick embryos three- 
quarters of an inch long shall not get into the stenching 
mess). And, when Christ's poor are treated like that, 
people have the Olympian nerve to speak of ours as a 
Christian civilization! 

Then there is the ghastly inhumanity of gauging hu- 
man labor by a law of supply and demand — a law nat- 
ural only in so far as it is evolved out of human greed 
and human meanness — of valuing labor as one does lum- 
ber or pork or junk. 

Tuberculosis is neither a hereditary nor a family dis- 
ease — but a house disease, contracted chiefly in un- 
healthful tenements and workshops. A decade ago, when 
the idea of model tenements for the poor was launched 
doctors working among the tuberculous rejoiced; for 
here, it was felt, would be a most potent agency against 
the disease. But the model tenement of to-day is not for 
the poor — not in New York nor in Chicago ; and Mr. 
James Bryce says it is not for the poor in London. 

Nearly ten years ago, with what strength and clarity 
there was in me, I set forth such things as these in 
my book, "Consumption and Civilization"; things my 
colleague, in your columns, gives the impression — all 
most unwittingly — that I have never considered! 

A preacher, on Tuberculosis Day a year ago, pro- 
pounded the question "Does God Fix the Death Rate" ; 
and he nobly answered himself, that God does not fix 



36 A DOCTOR'S VIEWPOINT 

the death rate. His God was not that kind of a god; 
his Providence no such providence. Man fixes the death 
rate by the war (industrial or with ordnance), the 
famine and the pestilence he makes; and by the same 
token, these unholy things are man-preventable. 

WHO, THEN, FIXES THE DEATH-RATE? 

Who, then, does fix the death-rate? 

Those theologians, now happily diminishing in num- 
ber, who ignore the demonstrated facts of preventable 
disease and seek to perpetuate the mediaeval superstition 
that infections are the Almighty's merited scourges; 
those laymen who consider they are not their brother's 
keeper and who disparage a tuberculosis propaganda 
as of no personal concern to them; legislatures which 
give millions of the people's money for schemes that so 
frequently turn out crooked, when they will not give a 
thousand to health departments, for fighting a com- 
munal disease that destroys 10,000 lives a year — 27 a 
day in one city alone; venders of patent medicines 
(mostly alcohol) and consumption cures, nostrum 
fakers who fleece their victims until the latter have 
passed far beyond the incipient stage in which phy- 
sicians could have helped them; a "league for medical 
freedom," organized to prevent the wise centralization 
and co-ordination of health activities ; those who over- 
work women and children in factories and are respon- 
sible for sweat-shop atrocities ; those employers who 
require men to work at dangerous trades under intoler- 
able conditions (some industries hold a consumption 
death-rate above 80 per cent.) ; those faith-healers and 
miracle-mongers who would blind the sick to the facts 
of disease until no cure can be done. Here is an army, 
having no conscience and owning no religion, that fix the 



ELIMINATION OF TUBERCULOSIS 37 

death-rate, which competent physicians, sanatorians, 
and humanitarians are trying — against such titanic 
odds — to lower. 

I hereby earnestly implore the laity to be hence- 
forth on the side of those forces that are bringing 
down the death-rate instead of training with malign 
battalions that are in the business of sending it up. 

Dr. Latham is right. Our civilization has been most 
perversely leaving the brink of a frightful precipice 
unguarded while at the bottom are we doctors, Dr. 
Latham and the rest of us, helping to restore what 
few we can among the hosts that have fallen into the 
depths below. And though thousands have been helped 
and many fully restored, every third or fourth adult 
white and every other adult negro among us could 
not be helped and has succumbed entirely. 

Well, what's to do ; are we going to keep on standing 
for all this? 

Goethe was told that a certain situation "must be 
so" — there was an immense authority and custom in 
favor of its being so — it had been held to be so for a 
thousand years. To which he answered: "But is it so ; 
is it so for me?" 

Lister, as a student in surgery, was told that putre- 
faction in wounds was due to the oxygen in the atmos- 
phere ; and there was no other way but that people had 
to die most horribly of gangrene, in fetid hospitals. 
But all this did not suit Lister; it was not so for him. 
And by his initiative humankind was freed of such con- 
ditions that Dr. Wrench, in writing about them, warns 
the squeamish reader to leave off with the beginning of 
the description and go on to the next chapter of his 
book on Lister. To-day — a short generation after — 



38 A DOCTOR'S VIEWPOINT 

we are amazed and disgusted at a civilization that would 
placidly endure such condtiions. 

The Panama Canal, of which Balboa dreamed, and 
of which Charles V was prescient, could never be built, 
declared Humboldt and Froude, because the isthmus was 
about the rottenest pest-hole on the globe ; and De Les- 
seps' honorable failure was in large measure due to 
that fact. But all this did not daunt Gorgas; it was 
not so for him. And he forthwith made a canal pos- 
sible — be assured it could never otherwise have been 
built — by transforming that region into a veritable 
health resort, with a mortality rate only two or three 
American communities can get under, and which is the 
despair of most others. 

TUBERCULOSIS CAN BE CONQUERED 

Tuberculosis can be eliminated from human experi- 
ence ; all we have to do is to determine not to stand for 
it. A century ago he who would have said such a thing 
about smallpox would have been declared fit only for a 
madhouse. For smallpox was decimating cities and 
wiping out whole towns and villages. The smallpox 
conditions of those days did not satisfy Jenner; so he 
went to work to get rid of that pestilence. And they 
called him mad, and a lot worse. And yet how prac- 
tically obsolete is smallpox to-day; in 1912 just two 
smallpox deaths among some five million people! And 
the method of getting rid of tuberculosis is simpler 
(though in practice the task is confessedly titanic), 
because we don't even know the germ of smallpox, while 
we have the altogether adequate knowledge of the germ 
of tuberculosis I have outlined, and know precisely how 
to cope with it. 

Is then the prophecy unreasonable that our posterity 



ELIMINATION OF TUBERCULOSIS 39 

a century hence will read with contempt and abhor- 
rence of a civilization so stultified that, having the 
clear preventive knowledge, it continued to be con- 
tent with so loathsome a thing as consumption? 

Much has been done admirably by individual altruists, 
by societies, and by Governments, against tuberculosis. 
But the kind of work that has thus far been done will 
never completely eradicate the disease, because it does 
not deal adequately with the basic evils by which the 
Captain of the Men of Death does his gleaning. 

And yet we are getting on. Conditions are not nearly 
so bad as they were a decade ago. While the rots and 
spots man still remains above ground, we have neverthe- 
less (at last there is some real statesmanship in Wash- 
ington) got the detestable tariff reduced from an aver- 
age of 42 per cent, to an average of 26 per cent. ; for 
all that it is still the miserablest laurel ever set on 
Mammon's brow. And we are somehow coping 
too with the Captain of Industries who bloodsweats his 
millions out of the poor, by demanding, and pro- 
gressively getting, the living wage. 

And if we could but unload ourselves of the charity 
broker, the charity politician, and the philanthropist 
who talks about "human derelicts' 5 and "undesirables, 55 
we might be able to house the poor, the really poor, in 
wholesome tenements — a hundred model tenements for 
every one such now existing — and all conducted on a 
frankly business basis. 

One must see how the tuberculosis problem is be- 
ginning to engage the consideration of discerning states- 
men, who grasp the idea that all good government exists 
primarily for the maintenance of the home. And where 
is the home, what the human relation, what phase of our 
infinitely complex civilization, that is not wretchedly af- 



40 A DOCTOR'S VIEWPOINT 

flicted by the Great White Plague? Disraeli, Lecky, 
Goldwin Smith, Hughes — such men have and do com- 
prehend this. Why, indeed, wait for future generations 
to act? To-day the end may begin to be fought for if, 
abjuring the tutelage of private enterprisers, and under 
the Presidency of our greatest statesman since Lin- 
coln, our people will but determine to possess in them- 
selves the sovereignty for which Washington and our 
fathers fought. 

Another fine thing about Goethe. A man came to 
him with a tremendously difficult task and feared he 
could not get away with it. "Ach," answered Goethe, 
"all you have to do is to blow on your hands !" 

Go to it, brother ! 



DANGER SIGNALS 

These observations are addressed to the man of forty 
or thereabouts. My hope is that whoever needs to be, 
or thinks he needs to be, made young again in body, 
may find herein something to his ends. To begin with, 
I haven't the slightest notion of "throwing a scare" 
into anyone; as regards most people there would be 
very little reason for that. In reading about these 
danger signals (erected to flag the man on the street 
against ailments to which those of us over forty are 
more or less prone), let no one imagine that the jig 
is up for him, or that he can now see the grim specter 
beckoning — not by a long shot! I am especially con- 
cerned to make this preliminary statement, because a 
man's health and his hope of longevity are absolutely 
his most precious possessions ; consequently when he 
gets morbid about his physical condition, his imagina- 
tion often works terribly overtime. I am going to wind 
up with something about "factors of safety" in our 
bodies, which will certainly reassure many who, recog- 
nizing one or another of the danger signals mentioned, 
may conclude themselves to be down and out. My idea, 
then, is not to disturb, but only to urge, the man of two- 
score to take thought, in order that he may safely and 
pleasantly attain to his three-score and ten. And there 
will be no information as to "what is good for" this, 
that, or the other individual complaint or "misery"; 
the family doctor is the man to go for such advice, as 

41 



42 A DOCTOR'S VIEWPOINT 

well as for consultation whenever anything is wrong in 
one's "innards." 

EVERYBODY LOVES A FAT MAN 

A great many of us are born with body habits, and 
others of us just naturally acquire them, after birth; 
doctors call these habits temperaments, or, tendencies, 
or predispositions. To be born with them does not 
necessarily mean that we are born with the diseases they 
lead to or represent. In fact, abnormal heredity 
doesn't count nowadays for nearly as much as it used 
to; we are seldom born with the diseases themselves, 
but rather with tendencies to them. And these latter 
may manifest themselves as the real thing sometimes 
very late in life. And it behooves the wise man to recall 
anything of that sort in his family history; and then 
to guard especially against the disease to which it may 
lead. Here are some of these body habits: 

Tall thin specimens, with slight small bones, slender 
ribs, and long narrow chests (that you can run your 
knuckles along as on a zylophone or a washboard) had 
just as well take a little interest in the present anti- 
tuberculosis crusade — especially if those with that kind 
of make-up have oval faces, a romantic expression, 
bright eyes, delicate skin and coloring, and run to art 
or poetry. 

Some people are born with a tendency to obesity; 
these are by far the best-natured among our fellow 
citizens. Let such a one never hope to be lithe and 
willowy throughout his life on this mundane sphere- 
that is, if he is born with the obese temperament; the 
star part in "Patience" is not for him. Or, if a lady 
thus "tendencied" reads this, let her not hope to curl 
up in a buttercup, like the Fairy Queen in "Iolanthe." 



DANGER SIGNALS 43 

Those who acquire "heft" in life are oftentimes 
"reduced" effectively enough, if they will only have the 
will power to stay so by keeping away from the flesh- 
pots. And why should the fat man want to bant? 
"Nobody loves a fat man." Nonsense! Everybody 
loves a fat man. Jollity, eupepticism, oleaginous geni- 
ality constantly ooze from him to bless and permeate 
civilization. The fat man is optimism's best asset ; how 
cheerless we would be without him. The tendency to 
obesity is almost never successfully combated; and yet, 
seriously, there are some diseases of later life which 
depend on fat deposition in various organs, and against 
which it were well for the stout individual to guard 
when he turns fort}'. 

how's your liver? 

The short man, with the chest wide and round and 
large, must not aspire to play the trombone, or to 
march in a band tooting that huge instrument which 
encircles the body ; and such occupations as glass blow- 
ing must be eschewed by such a one. For he has a 
tendency to wheeziness, to barrel chestedness, and to 
short windedness, which is likely to grow on him later in 
life — as with the undertaker in "David Copperfield." 

Then there is the gouty temperament, which from 
time to time, according to the medical fashions of va- 
rious eras, has been called the arthritic, or the rheu- 
matic, or the uric-acid or the lithemic habit. Such 
people are apt to be pretty good livers, generally robust 
(seemingly so at any rate), well developed as to body, 
the face florid, the hair thick (and sometimes iron gray 
quite early in life), good teeth, the appetite hearty, 
good digestion, and a strong heart with high-pressure 
arteries. A century ago — in the days of the three- 



44 A DOCTOR'S VIEWPOINT 

bottle men — people of the gouty habit were prone to 
wine, especially port ; to-day the trouble is not so much 
with drinking as with too much eating. (Pretty nearly 
all of us do that.) So the gouty have to prepare them- 
selves against arterial and heart changes, kidney and 
liver trouble and apoplexy. It is quite as true to-day as 
when the dictum first appeared some twenty years ago, 
that a man is just as old as his arteries. With these 
physiological hose pipes (which deliver blood instead of 
water) sound, elastic, and unrupturable, their owner 
is young at seventy ; he who has them of poor material 
is like to be old at fifty. And that venerable "Punch" 
joke — "Is life worth living? it depends on the liver" — 
is fraught with wisdom, as are almost all really good 
jokes. 

RICKETS VERSUS EUGENICS 

On the other hand, there is the lymphatic tempera- 
ment — those who have been born rachitic, weak of body, 
poor blooded, not well developed, prone to catarrhs ; 
they have little power of resistance and are constantly 
in danger of contracting some serious disease. Such 
people have in times past been among the world's 
greatest benefactors. It seems as if Providence, by way 
of compensation for their bodily handicaps, had given 
them noble souls, triumphant over their bodily ills 
by their indomitable wills, masterful men as to their 
brains, geniuses in literature and the arts and in world- 
enriching sciences. The human race cannot afford to 
let such inspiriting examples as these pass away un- 
timely; nor should there be occasion for that. Almost 
all these fellow mortals can be built up and made virile 
and able-bodied, as fit physically as mentally ; and can, 
with proper care and guidance, live as long as any 
of us. 



DANGER SIGNALS 45 

Then there is the neuropathic temperament ; and this 
is a hard proposition: because there is so much innate 
cussedness in these very trying, though often most lov- 
able specimens. And here it must be emphasized that 
there is no inherited tendency which cannot be success- 
fully fought and downed — except possibly alcoholism, 
especially when it is bequeathed by both parents. But 
even thus handicapped, one can win out if he can 
keep from the Great White Way, go off on a ranch or 
to Patagonia, or anywhere outside of civilization, with 
a mentor able to help him control his addictions and 
his perversities — a dominant mentor, who could on oc- 
casion, if need be, hand over a good, healthy, corrective 
wallop, 

EVEN NEUROTICS CURABLE 

And as to the sin of the father which was visited 
unto the third and fourth generation, modern medical 
science has proved that, alone and uncomplicated, it 
seldom endures beyond the second generation — often, 
indeed, is not transmitted at all, although the Men- 
delians seem now to have something to say as to that. 
And yet it is an awful thing to have acquired; if you 
don't believe me, go and see Ibsen's "Ghosts," a play 
perfectly well founded on scientific fact. 

The drug failings also are likely to be manifest in 
people of the neurotic temperament. And yet there 
is no drug addiction — cocaine, opium, absinthe, 'or 
any other — which cannot be triumphed over if only the 
right kind of fight is put up. 

Just a parenthesis here about the acquired habit 
of taking the coal-tar drugs, acetanilide, and so forth, 
for headache and for that feeling the morning after. 
It is dreadful how prone young people are to these 



46 A DOCTOR'S VIEWPOINT 

things. I recall how, at lunch one day, our maid 
appeared with the face of a corpse, and with lips 
as blue as the ink I am now using. We sent her at 
once to bed, and upon investigation, this was the 
cause of her appearance: That morning I had re- 
ceived an advertisement of a coal-tar product, with 
tablets to trj^ on my patients; as usual I promptly 
chucked the whole into the wastebasket. The maid 
in the morning found these tablets in the box, with the 
legend on it that they were good for headaches. She 
took not one but several, with the result narrated. 
Had I not restored her, she might have been fatally 
poisoned; nor would hers have been the first case of 
this kind, by any means. 

Well, to return to the neurotic temperament: this 
can be triumphed over and brought to normal, but in 
most cases only after the bitterest kind of struggle. 
Remember that the three modern fates which govern 
human destinies are heredity, environment, and will. 
When the heredity is bad we have to offset it by a 
combination of environment and will, each of which is 
at least as powerful as heredity. So let the neurotic 
get into the outdoor world, which is his best en- 
vironment; and let him gloriously exercise the divine 
human will. Then, believe me, he can triumph over the 
demon that would otherwise destroy him body and 
soul. 

THE PACE THAT KILLS 

And now a word about infection, heart disease, anii 
the pace that kills. In England it has been found that 
one-third of all the deaths between fifty-five and sixty- 
five come about through damaged hearts ; in the United 
States there has been during the last decade a con- 



DANGER SIGNALS 47 

stantly increasing percentage of deaths from this cause. 
All doctors know that this is largely by reason of the 
worry, the hurry, the strain, and the dreadfully high 
pressure of modern commercialism, and social distinc- 
tions, and the mania for wealth — factors which tend 
to undue wear and tear of the precious organ which 
must supply the body with its life-sustaining fluid. The 
nervous system, which is basic for all existence, and 
which especially controls the circulation, is in one who 
feels that he has to cope with and be in and of the 
madding crowd, in constant stimulation. But apart 
from the nervous system is the fact that men of affairs, 
who have come down with pneumonia, grippe, or a like 
infection ( the toxins or poisons in which are dreadfully 
disintegrative of the vital organs) can simply not be 
made to take the prolonged rest which is imperative 
for convalescence from these infections. Many of these 
patients — and elderly men too — are in their offices 
when they should most decidedly be in their beds. "Such 
a fussy lot, those doctors," declared one such ; "besides, 
an old horse that once lies down never gets up." He 
put on his overcoat, went to business, returned that 
afternoon in collapse, and died next day. Another, a 
grippe convalescent, concluding he never felt better in 
his life, told his doctor to go hang, went downtown, and 
died in the evening. Another, a pneumonia convalescent, 
sits up to play cards with his wife, and drops back 
lifeless upon his pillow. 

The fault is not here with the doctors, to whom it is 
not given to command the manners and customs of the 
age; they can but warn against fast living and against 
business habits conducive to such tension as must in- 
evitably lead to an untimely break-up ; they can but in- 
dicate the fever, the weak and uncertain pulse, the dysp- 



48 A DOCTOR'S VIEWPOINT 

ilea, the blue lips, the cold finger tips, the ashy face, the 
distended veins in the neck — and tell the dire meaning 
of these danger signals. 

And now as to the tendency to cancer : Many deaths 
from this disease occur after forty-five years ; and most 
deaths between sixty and sixty-four are due to it. While 
consumption destroys humankind from adolescence to 
life's prime, cancer claims the greater number of victims 
in the afternoon and evening of life. And it is a curious 
phase of the law of compensation, that while consump- 
tion, the Captain of the Men of Death, destroys mostly 
civilization's submerged strata — the poor, the starved, 
and the exhausted — cancer on the other hand does the 
larger part of its gleaning rather among the well-to-do 
in life, those who have never felt the stress of poverty. 
Patrician cancer has a predilection for the homes of the 
prosperous. Cancer loves a shining mark — the illus- 
trious, those of great worldly importance, those whom 
communities can ill spare, those who have, through 
many years of superb activit}^, fairly earned ease with 
dignity in a serene and respected old age. Nor is there 
any disease so insidious as cancer. Therefore let the 
man after forty, especially with cancer in the family 
history (though there is very little in cancer heredity), 
who notices any inflammation in the mouth, or whose in- 
digestions are not easily relieved, or who has inex- 
plicable pain in the abdomen ; or the woman whose func- 
tions natural to her sex seem abnormal — let such suf- 
ferers frequently consult medical advisers of tried skill 
and reputation. 

DO NOT WORRY 

And finally about those factors of safety; they are 
our reserve forces, which avail us in time of undue 



DANGER SIGNALS 49 

stress and strain, and which keep our bodies in fairly 
normal condition, despite the many chances we take 
and the various agencies inimical to human existence. 
The term was borrowed by Dr. Meltzer, of New York 
City, from the mechanical engineer, who must esti- 
mate the margin of safety required in constructing 
engines, bridges, and so forth. In mechanics it is cal- 
culated that given structures should be capable of with- 
standing not only the stresses of reasonably expected 
maximum loads, but also those of several times such 
loads. The factor of safety in mechanics is founded 
upon finite human ignorance of what might happen; 
and upon a wise desire to provide against contingencies. 
So the Creator has provided us with latent forces ; the 
potential energy of many organs far exceeds the needs 
of normal, everyday humdrum existence. Surgeons take 
away a diseased kidney; and the patient gets along 
comfortablj' with his remaining kidney, living often- 
times to attend the funeral of many of his friends not 
thus handicapped. Then, again, four-fifths of his liver 
has been removed from a dog, who keeps happy there- 
after with his remaining fifth ; and so on. In the case 
of many of our functions the necessary mechanisms are 
doubled and even trebled. The function of one organ 
is often assisted by those of other organs. Living tissue 
is provided with one important factor of safet} r which 
is peculiar only to living things, and not to any other 
kind of machinery — that is, the means of self-repair. 
These factors of safety promote the integrity of life, 
the perpetuation of the species, and have an important 
bearing on the process of natural selection. And phy- 
sicians know that most men and women complete the 
human span of life, despite the many diseases (some- 
times indeed, despite the treatment for them), despite 



50 A DOCTOR'S VIEWPOINT 

accidents, and other untoward circumstances to which 
humankind is constantly subjected. 

So do not worry ; but do heed a danger signal, espe- 
cially when it lights up after forty! 



THE PREVENTION OF CANCER 

Cancer is one of the few problems remaining for 
medical science to solve. Its essential nature is not yet 
fully determined. But the study of it is intense; the 
civilization-wide field has, for a generation past, been 
entered by so many able and experienced delvers, all 
in generous rivalry to be the first to bestow upon their 
kind the epic boon; so abundant are the material re- 
sources which the sympathetic rich have put to the 
service of these workers ; so noble and so distributed are 
the cancer research institutions (justifying the claim 
of Harvard's President Emeritus that no religion can 
be valid which does not recognize the beneficence pro- 
ceeding from their walls) ; so loyal is the co-operation 
of governments — that the unraveling of the cancer 
mystery cannot surely now be longer delayed. I shall 
advert to the prevalence of cancer; how it invades the 
human organism in its prime— the world worker upon 
whom human progress depends, the mother to whom 
humankind must look for its life; how practically in- 
curable is cancer when once established ; and other most 
momentous considerations: but my emphasis will be 
laid on the possibility of preventing half our cancer 
cases by prompt and adequate action in the "precan- 
cerous stage." "What cannot be cured must be en- 
dured" is an excellent dictum, satisfactory, like all 
philosophic reflections, to those who have not, nor need 
fear the incurable thing ; but neither the cancer sufferer 
nor his physician can get much comfort from it. And 

51 



52 A DOCTOR'S VIEWPOINT 

Doctor Parker Syms, in an address on cancer under 
the auspices of the New York State Medical Society, 
has given us a better saying, that "what cannot be cured 
may be prevented." 

THE PREVALENCE OF CANCER 

Cancer is considered to be very much on the increase, 
although this may be only apparent and by reason 
that our modern statistics are better prepared and based 
on more accurate knowledge and observation. For my 
part I must believe that there is an increase. Because, 
unlike tuberculosis, which affects mainly mankind's sub- 
merged strata — the starved, the ill-clothed, the devi- 
talized — cancer has had comparatively, by no means 
always, a patrician predilection; its tendency, except 
for the superficial cancer, which results mostly from in- 
juries is for those after forty, in whom eupepticism un- 
relieved by exercise in this motor car age has left, as it 
were, unburned or unassimilated klinkers to clog and 
corrode the bodily machinery. Then, too, twentieth cen- 
tury preventive medicine has been wonderfully instru- 
mental in preserving the lives of many who would for- 
merly have died in infancy and youth; and certain of 
these survivors have probably later on contracted can= 
cer and added to the percentage of its incidence. 

However these things may be, cancer is known to 
affect humankind exceptionally before the twentieth 
year, rarely before the thirtieth, whilst most of its vic- 
tims are between thirty and old age, the majority being 
between forty-five and sixty-five. The disease is con- 
siderably more than half as prevalent as tuberculosis. 
The latter, The Captain of the Men of Death (in John 
Bunyan's tremendous phrase) has been destroying every 
third or fourth adult white life and every other negro 



THE PREVENTION OF CANCER 53 

life between adolescence and fifty. Cancer is nearly six- 
tenths as prevalent as heart disease. It is nearly as 
prevalent as pneumonia, which in certain times and 
places has had as high an incidence as tuberculosis. 
In the United States there are now nearly eighty thou- 
sand cancer deaths annually. In England one woman 
in ten dies of cancer and one man in eleven. The disease 
prevails more among women than among men because 
in most women it attacks the organs peculiarly fem- 
inine. Apart from this, cancer prevails more among 
men, especially that of the lips and stomach. 

WHAT IS KNOWN ABOUT CANCER 

Cancer is a malignant growth, malignant because 
its tendency is to increase and ramify into previously 
healthy parts of the body, until it destroys life. The 
word means crab ; and by it some Greek many centuries 
ago, with the genius of his race for trenchant char- 
acterization, expressed the insidious, tenticle-like reach- 
ing out from the sinister growth until ascendancy has 
been gained over the sufferer. One sees here also why 
operation must not be delayed until the offshoots, every 
one of which must for a cure be entirely removed, in- 
vade regions often remote from the original seat, and 
which the surgeon cannot safely reach. For, if any 
cancerous tissure remain, there will, with very rare ex- 
ceptions, be recurrence months or years afterward, with 
practically no hope of permanent or positive cure in 
the present state of medical knowledge and experience. 
Complete removal by the knife of a strictly localized 
cancer, before it begins to ramify, will give a cure — 
the only assured cure. But a cancer, at first a purely 
localized disease, is like in time to have portions of the 
primary tumor conveyed elsewhere through lymph and 



54 A DOCTOR'S VIEWPOINT 

blood channels ; and when such secondary growths ob- 
tain science has no remedy to give. 

It were hardly well, except in the medical press, to 
amplify such considerations ; the physician's consulta- 
tion should bring them out. But certain things are 
appropriate to be stated here. There is little if any 
reason to believe cancer to be hereditary ; nor that it is 
a communicable, infectious disease; nor that it pro- 
duces in the sufferer a future immunity in the way 
that he who has, for example, an attack of smallpox 
need never again fear that disease; nor is there at 
present a specific cure for cancer, by drugs or chem- 
icals, of serums or vaccines, although some superficial 
cancers appear to have been cured by the use of radium 
and other such means. 

THE PRECANCEROUS PERIOD 

We know this most important thing about cancer — 
that there are certain bodily conditions and certain ail- 
ments predisposing to its development, and which con- 
stitute the precancerous state or stage. Except after 
blows or other injuries cancer will not develop in normal 
tissues. It is by recognizing this stage in time that 
forty thousand of our people can annually be saved 
from death by this apalling affliction. 

How is this to be done? Nearly half the cancers 
have a precancerous stage that ought to have been de- 
tected. "Benign" tumors, not in themselves death-deal- 
ing; prolonged irritation; disturbances of function 
through years; chronic ulcerations, especially of the 
stomach; inflammations; injuries, abnormal tissue, as 
scars or stumps from old operations — such are con- 
ditions which must be feared as leading to cancer. 

Every benign tumor, however innocent to begin with, 



THE PREVENTION OF CANCER 55 

is a potential cancer; if "operable," it should be re- 
moved, lest cancerous infiltration take place in it. Thus 
may not only a definite and permanent cure be vouch- 
safed; but also such a relatively slight and shockless 
operation give the least disfigurement or mutilation. 
Certain kinds of moles (birth marks) may take on 
malignancy; if these were removed in the precancerous 
stage there would most likely be no recurrence and no 
internal migrations of the cancer cells to other and re- 
mote parts of the body. When these moles have be- 
come definitely cancerous they are exceptionally seri- 
ous. 

Cancer is always a tumor, a swelling, a "lump" as 
many people say. The laity are apt to think of a 
tumor as necessarily meaning a cancer. But to the 
doctor any kind of a swelling (and there are at least 
a score of them) is a tumor. Also there are several 
kinds of cancer, differing in the degree of their malig- 
nancy and in their course. Superficial cancers, as those 
of the face or lip, are reasonably recognizable by sight 
and touch and by a microscopic examination. Imme- 
diately such a thing appears medical consultation must 
be had. Of course, such a thing may not be cancerous ; 
further description is withheld in order not to arouse 
pathophobia. Deep-seated cancers are much more dif- 
ficult to detect ; oftentimes the only indication of them 
is a functional disturbance of the organ or tissue in- 
volved or perhaps also of other and associated organs. 
Wherefore those after forty, especially women, and cer- 
tainly those after forty who find their health not as it 
has been should go without delay for a medical ex- 
amination. 

Irritation prolonged through months and years all 
too often leads to a cancer at the site of the irrita- 



56 A DOCTOR'S VIEWPOINT 

tion. Thus there is the clay-pipe cancer; there used 
to be the chimney sweep's cancer; there is that of the 
tongue from the jagged edge of an untreated tooth; 
the laryngeal cancer, from the inveterate smoking of 
strong tobacco; the cancer from X-ray burns (how 
long the list of medical martyrs who have suffered 
thus) ; the cancer from prolonged exposure to the sun; 
that from insect bites or intestinal parasites ; that from 
betel- nut chewing in India; from eating very hot rice 
in China; the kankri cancer in Thibet, (The natives 
carry in their tunics a pocket stove, the kankri, the 
constant use of which is followed by cancer at the 
site of the burn.) 

Prolonged disturbance of function not amenable to 

ordinary treatment should excite suspicion that has im- 
peratively to be dissipated; especially is this so of the 
digestive apparatus. Function and structure are as 
inseparable as mind and matter; abnormal function- 
ing must inevitably lead to diseased structure. Anemia, 
nausea, indigestion, loss of appetite, of weight, strength 
and stamina, jaundice, bleeding from the stomach, un- 
easiness, pain and tenderness on pressing below the 
breastplate — such things should exite apprehension that 
has to be dissipated. Gastric pain has been consid- 
ered to indicate cancer and its absence to remove the 
occasion of fear; but here were a broken reed to rely 
on, for even advanced cancers have given no pain. 
These warnings must be emphasized for men after forty 
who have been alcholics or habitual eaters of irritating, 
indigestible and super-abundant food. And the most 
heartrending cancer cases are those of women who have 
neglected the warnings given by discomfort and func- 
tional disturbances. 



THE PREVENTION OF CANCER 57 

THE CURABILITY OF CANCER 

Cancer is curable in many cases; some forms of it 
are much more easily curable than others ; and cancers 
in certain parts of the body are more curable than 
those in others. The disease is always localized at first : 
operation then especially by the recently evolved and 
most beneficient procedures for which the world is in- 
debted to Doctor George W. Crile of Cleveland, would 
mean the removal of the entire growth and cure in many 
cases. How many? Some operators have demonstrated 
eighty per cent, of cures. Operation not early, and 
with extension, has given fifty per cent, of cures. But 
when complete removal is impossible, operation will work 
temporary relief; but there will be recurrences and no 
absolute cure. Though many other methods of dealing 
with cancer have been and are being tried and advanced, 
they are at present all experimental, nor can the value 
of any of them be vouched for. 

WHAT IS THEN TO DO 

Much, then, that is preventive can be done in the 
precancerous stage. When any sign here indicated is 
obvious, give place to the physician, who will call if 
need be a surgeon into the council. But operations are 
such dreadful things ! Nonsense ! They are to-day, the 
most of them, no worse than a holiday jaunt. Anes- 
thesia is nowadays so perfected that it is positively de- 
lightful and safer than a joy ride, by far. The anes- 
thetist is like to ask the woman patient what is her fav- 
orite perfume — rose, lavender, violet; the man his fav- 
orite cocktail? A turn at the apparatus is made; one 
inhales the delicious fragrance, and has hardly the time 
to enjoy it when nature's soft nurse has intervened. 
Dangerous? Surgery is nowadays so nearly ideal that 



58 A DOCTOR'S VIEWPOINT 

remarkably little risk of life is entailed. Why, bless 
you; the operating table is almost the safest place in 
existence; though later operations are confessedly ex- 
tensive, severe and dangerous, operation for the early 
cure of cancer has a mortality of no more than one 
per cent. And think of the rest one gets. A fortnight 
or so of absolute relaxation in bed, a rest such as al- 
most every man or woman among us, sick or well, would 
be the better for. How much better off indeed, would 
the whole country be if such felicity (as they say in 
the minstrel shows) should eventuate. 

Don't delay. Even as things are now sixty per cent, 
of superficial cancers and nearly forty per cent, of 
those deep seated are operable, with very fair pros- 
pects of cure. By earlier operation proportionately 
better success would be attained. 

Nor rely on palliatives ; nor on faith, mind or healer's 
cures (How would the Master, with His "if thine eye 
offend thee, cut it out" abhor such unholiness.) And 
has finally the cancer got beyond remedy? Then must 
philosophy and religion bring their consolation (this 
they did in other eras — why should they not in ours) ; 
whilst the physician, though he cannot give euthanasia 
can nevertheless assuage the suffering and make it en- 
durable. And St. Paul could give help too. For when 
he besought that his incurable disease, his "thorn in 
the flesh" might be made to depart from him, and it 
did not, despite his prayers (for there was no miracle, 
even for one so worthy) he was comforted by the divine 
assurance "My grace is sufficient unto you." 



DON'T BE A HERMIT CRAB. 

"I have read somewhere," observed the doctor, "how 
a naturalist, studying the difficulty a butterfly had in 
breaking from its chrysalis, determined to help along 
the little creature's will-to-live by cutting through some 
impediments that bound it, so that it could the more 
easily free itself. And what had that tender-hearted 
scientist accomplished by his helping? Instead of com- 
ing out strong and beautiful, the butterfly was a frail 
thing indeed. The struggle of which the mistaken kind- 
ness had relieved it was the very source of the strength 
of the body and the irridescence of wing it should have 
begun life with. 

"It is the same way, I understand, with ducklings 
that are helped from their shells. They differ from 
those that just have to struggle out in being stunted 
any puny, if indeed they do not have to die at once, or 
soon after the too-kindly hand has helped them out of 
the egg shell stage of their development. 

"The other day I visited the aquarium at the Battery 
in the metropolis. In that most absorbing panorama of 
fish life, from the ingratiating seal down to the tiny 
sea-horse — a specimen of which that profound though 
untutored psychologist Barnum worked off on the 'easy' 
American of his day as a mermaid, a horse on the public 
as it were — in that aquarium are two adjacent tanks, 
one containing the real crab, the other a deplorably 
poor relation of his, the hermit crab. The difference 
is decidedly worth considering. The real crab, in his 

59 



60 A DOCTOR'S VIEWPOINT 

native waters, leads a rough and perilous life, among 
jagged rocks. He is dashed about by every wave, whilst 
on all sides his piscine enemies attack him. So his 
kind, throughout its struggle for existence, has through 
crab-aeons developed a strong and serviceable coat of 
mail — a hard shell. Certainly the real crab is entitled 
to admiration ; and he has businesslike appendages that 
excite a noli~me-tangere sort of respect. 

"But not so the hermit crab, whose forefathers long 
ago imagined they had hit on a good idea, when they 
stole into the well-built homes that had been developed 
and then abandoned by other mollusks. And what has 
been the result of such house-free policy? Why, gen- 
eration after generation this foolish kind of crab, dwell- 
ing in its stolen tenements, has ceased to bother itself 
about questions of safety or of any struggle for exist- 
ence, such as ennobles all forms of life that enter into it. 
Consequently, nature has written this sin against evo- 
lution, this semi-parasitism, most plainly upon the her- 
mit crab's organization, for any one to read and to be 
disgusted over. This miserable, shabby-genteel sem- 
blance of a crab, has suffered in its anatomy precisely 
to the degree that it has ignobly borrowed or filched 
from his neighbors. Not now a lusty, perfect, com- 
mendable, high-class crustacean, its body is sadly weak- 
ened, several of its vital organs are partly or wholly 
shrivelled up, and its sphere of life— with all the glory 
and satisfaction there should be in that — has become 
pathetically limited. Having by a cheap and unworthy 
expedient secured safety, it has in consequence fatally 
compromised its independence. Not now needing to 
construct its own coat of mail, a vital inducement to a 
life of dignified and vigilant exercise of its own powers 
is correspondingly withdrawn. A number of bodily 



DON'T BE A HERMIT CRAB 61 

functions have struck work; by a stern law of evolu- 
tion — that an unused organ must atrophy — the hermit 
has not only lost all power in certain parts, but also 
those parts themselves. Instead of the thick, chitinous 
shell of the self-respecting crab the hermit can now 
show only a membrane absurdly thin and delicate; this 
half-naked and woebegone hobo of the seas presents 
limbs now rudimentary, or so small and frail as to be 
but laughable excuses for limbs. And the only com- 
pensation for all this degeneracy is that such additional 
tail development as will permit it to hold on to its stolen 
retreat has been acquired through nature's suffrance. 
Obviously, in the near biological future the hermit spe- 
cies of crab will, by reason of its racial senility, become 
extinct. 

"There is an enormous amount of semi-parasitism 
and parasitism in the cosmos, so far as our ken goes. 
There are many forms of life — the dodder, the mistle- 
toe, and so on — that will not take the trouble to find 
their own food, but borrow or steal it from the more 
industrious ; here is oftentimes an acquired habit and 
a very bad one, for which nature invariably exacts a 
dreadful penalty. Almost every animal is a living 
poorhouse, harboring lazzaroni, supplying them gratis, 
not only with a permanent home, but with all the ne- 
cessities and indeed all the luxuries of life. The animal 
is thus an unwilling host, to its own prodigious dis- 
comfort; and often indeed to its death, by such rela- 
tionship. It is a most debatable philosophy, that of 
David Harum, that c a moderate amount of fleas is 
good for a dog — it keeps him from broodin' on bein' 
a dog.' 

"Now the point of all this lies in its application to 
the human parasites, of whom there are a vast number 



62 A DOCTOR'S VIEWPOINT 

subsisting on the rest of us ; this hurts us considerable, 
but it harms them a great deal more. In the biologic 
scheme the genus homo is conditioned as to his life 
processes, precisely as is every other creature in the 
cosmos. Man is most perversely stupid to imagine the 
universe to be anthropo centric so far as willing is con- 
cerned. In the presence of the eternal verities he is as 
helplessly pliable as any other sentient thing; the mod- 
ern fates — heredity, environment and function — master 
him as did those of mythology; and he cannot evade 
their shaping of him any more than can the dodder 
and the hermit crab. 

"They who eschew effort, and are unwilling for strug- 
gle and suffering are lost. And, whilst going through 
a process of self-destaminization, the indolent and the 
selfish inflict a most grievous phlebotomy upon the 
virile and the self-respecting portions of our really sub- 
lime race. The evil is obvious in various ways: for 
example, the charity that helps the individual to help 
himself is altogether laudable ; but indiscriminate alms- 
giving is a cruel wrong both to the recipient and to his 
community. Consider also the paternalism which 'just 
now is rather rife'; when will the body-politic come to 
appreciate that what its government bestows upon some 
of its people must inevitably — there can be no other 
source — be abstracted from the remainder of the citi- 
zens. The only way — there can be no other — by which 
the government can be humane and generous is by tax- 
ing you and me and Jones and Brown and Smith and 
Robinson." 

"I am inclined to believe," observed the evolutionist, 
"that all manner of charity is futile; and mistaken, in 
that it seeks, in violation of nature's laws, to preserve 
the unfit. Were it not after all better for the race in 



DON'T BE A HERMIT CRAB 63 

general if its weaklings were left to die off — humanely, 
of course; are not, for instance, efforts on the part of 
you doctors to save the lives of consumptives, espe- 
cially of tuberculous infants, really misdirected, in that 
they violate the Darwinian law of the survival of the 
fittest? 

Is not the continued existence of the weak an ad- 
ditional, an unfair and a useless burden upon the strong 
and a handicap upon the development and the progress 
of the fit? Were not the Spartans wiser than we in 
throwing their unhealthy born infants to the wolves— 
though of course I would not stand for any such thing 
as that, but only for a kind of blissful euthanasia, by 
which our unfit might be helped toward their oblivion. 
Anyway they considered — did the Spartans — that the 
claims of the individual and of the race involved in 
these respects a contradiction that could be sensibly 
adjusted in but one way: they would not save a sickly 
infant, because to do that would be contrary to com- 
munal hygiene, which would have for its ultimate ob- 
ject the improvement of the race." 

"And yet they were most deplorably mistaken, those 
materialistic Spartans" — here warmly broke in the hu- 
manitarian — "as history proved ; for they were eventu- 
ally overcome by the brainier though less brawny Athen- 
ians. 

"You err," continued the humanitarian, in consider- 
ing this tenet of the survival of the fittest to have only 
a physical, a materialistic phase ; whereas if it is to have 
the slightest value in philosophy, it has got to be indica- 
tive of evolution in all its aspects. Evolution, to be a 
philosophy worthy the name, has got to be an all-com- 
prehending system, upon which consistent living can 
be based; it has got to consider not only the purely 



64 A DOCTOR'S VIEWPOINT 

physical, but all other aspects of life as well — the men- 
tal, the moral, the emotional, the spiritual — an evolu- 
tion inclusive of the humanities. For no doctrine in 
philosophy is surer than that the physical, moral, men- 
tal, spiritual and all other phases of existence are in- 
separable and mutually affecting and affected parts of 
the individual being — monistic, in short. The most 
practical Gradgrind, the coldest political economist, 
the most austere Statesmen!, will grant this, as well as 
the most susceptible to the emotional — at least they 
will if they be men experienced in dealing practically 
with human conditions. On such basis then, a sympa- 
thy for the weak and the afflicted, and a helpful solution 
for their return to health and strength is altogether 
logical; otherwise the conclusion is inevitable that 
civilization, the wille zum guten, altruism, and of course 
Christianty, have been and are now colossal mistakes. 

"If," continued the humanitarian, "this broad view 
of evolution be accepted, who would dare take it on 
himself to discriminate or to select from among his 
fellows 'the fittest' for survival? There are just now 
some very well disposed people whose presumption in 
making these premises is making them ridiculous and 
even intolerable ; and are the eliminators and eugenizers 
themselves so immaculate that they need no attention 
in the premises? Who is to manage their business for 
them? 

"Many a useful man who has given substantial com- 
fort to others, has been unhealthily born and has had his 
infant life hanging month by month by a thread until 
the scale has been turned existenceward, with results 
most beneficial to his kind. The biographical diction- 
aries furnish the names of many a weakling who, having 



DON'T BE A HERMIT CRAB 65 

triumphantly grown to maturity, has impressed himself 
upon his civilization, to its great good and profit. 

"The case of Smiling Joe springs at once to mind. 
What! you've never heard of Smiling Joe? He is the 
little fellow that, having Pott's Disease of the Spine, 
lay for two years on his back, strapped to a surgical 
frame so that he might not die of bone consumption, 
or that, in any event, he might not grow up a hunch- 
back. There are those who would declare this poor, 
sick tenement child had better have been left to perish — 
or, speaking by the book, to undergo natural elimina- 
tion in the process of the survival of the fittest." (Here 
the evolutionist reddened and seemed pained, for he was 
really a well-meaning and good-hearted man ; they seem 
cruel but are not, those Darwinians ; it is only that 
they have to scrap in behalf of their theory.) "Well," 
went on the humanitarian, "by just lying on his back, 
and smiling through his sufferings, and keeping on 
smiling the smile that wouldn't and couldn't come off, 
tenement Joe effected more than most able-bodied men 
could ever have hoped to. Principally by publication, 
throughout pretty much all civilization, of a picture 
of his smile and of his patient little body strapped to 
that frame, a fund of a quarter of a million dollars 
was collected, with which they are going to build by 
the seashore a hospital for tuberculous children! 

"And yet, even in the evolutionist's creed (it is held 
somewhere, I believe, that there is in nature a constant 
struggle for recovery of lost perfection, a struggle in 
which she much oftener succeeds than fails — in the long 
run at any rate, if not in the first attempt. Is it not 
so (appealing to the doctor) that in medicine this 
striving after lost perfection is as much a part of na- 
ture's healing power as is the force making for recov- 



66 A DOCTOR'S VIEWPOINT 

ery — the vis medicatrix naturae, I believe the phrase 
runs — in most cases of sickness? And has it not been 
observed among physicians that weakly parents not 
infrequently beget strong children?" 

The doctor nodded appreciatively; for the humani- 
tarian was a man after his own heart. After all is 
said about the sordid, stolid and vivisecting medical 
profession, the doctor and the humanitarian are twin 
brothers. 

"Yes ; for example there are tuberculous parents 
who have had born to them virile children, whose 
chances against consumption, oddly enough, have been 
rather better than those of untainted parents. Before 
adolescence there are comparatively few deaths from 
tuberculosis ; the period when this disease manifests 
itself most and during which most deaths occur from 
it being between fifteen and fifty years. So there is a 
long period of latency when, if the child be well-en- 
vironed and nurtured, he will be likely to overcome such 
untoward tendencies as he may have begun life with. 
Here surely are evidences of an unright and honorable 
offer on the part of nature to remedy her defects. She 
surely is entitled to have us emulate her. We ought to 
help some ourselves and not expect either her or the 
Deity to do everything. 

"But to return to human parasitism. Obviously how 
to be both humane and wise is one of the most tremen- 
dous problems of civilization. It might well make 'an- 
other story,' as Kipling would say." 



THE COWARDICE OF BRAVE MEN 

The dinner had been delicious, the wines mellowing, 
the table setting exquisite, the flowers subtly fragrant, 
the lights soft and varicolored, the gowns of the ladies 
most symphoniously blended ; the ladies indeed had been 
adorably charming and gracious, whilst none of them, 
thank goodness, had been so rapturously beautiful as to 
disturb the evening's harmonious relations ; all betok- 
ened the truest kind of hospitality, such as a eupeptic 
bishop once extolled. The ladies having left for the 
drawing room the gentlemen lit up. 

"I have been reading," observed the bon vivant, sip- 
ping his liqueur, whilst his eyes turned beatifically to- 
ward Aurora (with her attendant maidens) on the 
ceiling — I have been reading of a Frenchman who, 
whilst visiting New York, was so afflicted with germi- 
phobia that he abruptly cut short his visit and suddenly 
returned to that dear Paris, where in his belief germs 
are fewer or anyway more amenable to restriction than 
in the rampant New York atmosphere." 

"Fear is indeed a curious thing," said the member 
of the opera club. "I remember that at the time of 
the earthquake in San Francisco the Metropolitan 
Opera House singers were visiting that city. Among 
them was a justly famed basso prof undo, several inches 
over six feet, of physical architecture superbly propor- 
tioned to his height, and of noble, indeed most martial 
bearing. In the course of his operatic engagements 
his roles frequently called for feats of desperate hero- 

67 



68 A DOCTOR'S VIEWPOINT 

ism; such as inviting, in stentorian tones, the whole 
male chorus to spit themselves, in turn on en masse (as 
to this he was indifferent) upon his naked blade. And 
his organ o'ertopped the whole orchestra, including 
the brasses, the kettledrums and all the rest thrown in. 
My soul is thrilled and wholly satisfied in the recollec- 
tion how this epitome of valorous ages did these turns. 
On such occasions I invariably felt I had the worth of 
my money and more, even without the gargling soprano 
and the rhinociferous tenor thrown in. Then came that 
earthquake, which wrought a most melancholy change 
in our full-throated cavalier; the shock, it seems, com- 
pletely disorganized his psychism — I think that's what 
those psychologists call it. For many weeks he was, 
like the Hibernian about to propose, all of a thrimble; 
the scene of his erstwhile spectacular heroism knew 
him not ; and when finally he did reappear, it was as 
the peace — adjuring, altogether innocuous monk in 
Romeo and Juliet" 

"Well," observed the scientific guest, "it wasn't the 
basso's fault if he was a less courageous man after than 
before the earthquake. Some might consider he hadn't 
been of heroic mold at all, only mimetically brave ; but 
I am not, for one, at all of that mind. I consider, in- 
deed, that there being so much of him, his proportions 
being so huge, he must have experienced a relatively 
greater shock, and have shown its consequences more 
than would a slight and wiry party. And what is 
shock? It is a profound disturbance of the normal 
interaction of the great nerve centres, and consequently 
of all the organs and tissues, which the nervous system 
controls and regulates. The cause of the shock will 
generally come from without. And overwrought emo- 
tions are very conducive to fear; how often have the 



THE COWARDICE OF BRAVE MEN 69 

affections unmanned men! Again, one dreads an an- 
ticipated event, such as having to make a speech; the 
fear of which is dissipated immediately the action is 
begun; the trouble is then to stop such a man, who in 
the halcyon realization there was nothing to fear after 
all, is like to keep on ad infinitum. Or the danger may 
be reasoned out; and the fear may lie in the assumed 
inability to cope with it." 

"Consider, too," said the doctor, "that all healthy 
living is the right adjustment of the body's functions to 
its external relations. And it is not to be wondered 
at that disorganization will follow upon so irregular 
and unexpected a thing as an earthquake butting into 
the customary environment. Then there is also the 
physical condition of the individual, his being perhaps 
below par, at the time of the hitherto inexperienced 
disturbance. 

"That is so," said the West Pointer. "Men strong, 
virile, well-fed, associated in companies and in daylight, 
each with his internal relations in good working order, 
will not so easily fear as those who are exhausted after 
long marches, starved, the body-machine not well fueled, 
isolated and at night. Yes, there have been glorious 
instances to the contrary, as at Valley Forge. Every- 
body knows, of course, about the two o'clock in the 
morning courage; any man brave then, when the body 
is weakest, is indeed a wonder. Recall, too, how Mul- 
vaney, after he had circumvented a few stiff drinks, "felt 
schornful of elephunts," and achieved his historic mas- 
tery of a mastadonic "rogue" that was terrorizing the 
neighborhood. And it is true that the unaccustomed 
things make one afraid : the soldier exulting in the smell 
of powder and the detonating ordnance might well 
tremble in the presence of a virulent plague ; the doctor 



70 A DOCTOR'S VIEWPOINT 

and the nurse, being accustomed to pestilence and held 
to cope with it, seldom succumb to infection, to which 
fear, I understand, is wonderfully conducive. We are 
all of us afraid until we get used to things. This has 
been so of many famous commanders — of Augustus, the 
victor at Actium, of Turenne, of Napoleon, of Nay. *A 
coward is he,' declared the bravest of the brave, 'who 
boasts that he was never afraid. 5 Demosthenes talked 
fight aplenty, but he ran away from his first engage- 
ment, as did also Cicero. I recall the incident of the 
Russian commander about to mount his steed; as he 
stood, his legs trembled — with fear. 'Damn you, 5 swore 
he, looking down and apostrophizing these unruly mem- 
bers ; 'for this I'll take you where it's hot !' Upon which 
he vaulted into the saddle, charged into the midst of 
the fight and was killed." 

"One of powerful imagination, of lofty temperament, 
of fine acute sensibilities," observed the novelist, "will 
evince fear such as would be beyond the comprehension 
of a clodhopper. And an apprehension of disaster, 
however ill-founded, may, like the crescendo in music, 
lead to a veritable palsy of fear, inhibiting reason — 
which is the most supermannish of our acquisitions, the 
last developed and the first to be relinquished: and so 
an abject and helpless terror seizes on one who could 
not fairly be called a coward. Kipling in one of his 
stories, describes the quivering dread of something that 
you cannot see, a fear that dries the inside of the 
mouth and half the throat, that makes you sweat on 
the palms of the hands, and gulp. This is a fine fear, 
wrote Kipling, a great cowardice, and must be felt to 
be appreciated. De Maupassant also wrote of fear 
(which, he said, the boldest man may feel) as a sort of 
(decomposition of the soul, a terrible spasm of brain and 



THE COWARDICE OF BRAVE MEN 71 

heart, a kind of reminiscence of fantastic terror in the 
past." 

"Well, then," said the scientific guest, "the essence 
of fear seems to lie in the instinct of self-preservation ; 
it is the signal to the sentient creature, human or other- 
wise, to protect himself as best he can, against hurt or 
death. But speaking of germiphobia. It is odd what 
a variety of phobias are experienced by people not es- 
pecially timorous, and who are only so with regard to 
the one phobia that particularly affects them. These 
fears are instinctive; sweet reasonableness plays no 
part in them. There is claustrophobia, the fear of 
closed spaces, which was so dreadfully suffered by 
Hamerton, who wrote the Intellectual Life, and who 
was in all other respects a superbly normal Britisher, 
a good rider, a swiinmer that could smoke his pipe in 
the water and all that sort of thing. Then there is, 
on the other hand, agoraphobia, the fear of open spaces 
which appears to be a legacy from our remote Simian 
ancestors, who were arboreal in their habits. Therein 
indeed lay their salvation from utter extinction, and 
the possibility of our own more or less fortunate exist- 
ence, through the Darwinian processes. Monkeys in 
the tree tops could with impunity satisfy their jocund 
propensity to pelt with cocoanuts the foe on the plain 
below. Comparatively feeble in body, they were safe 
only by reason of the agility with which they could 
climb out of reach and swing from bough to bough 
and tree to tree. But that monkey who descended to 
the ground was like to be done for; on the flat or in 
the jungle he had little chance against the spring of 
the tiger or the speed and wind of the wolf. So our 
arboreal forbears had an instinctive aversion to ex- 
tended excursions; and their present day descendant 



72 A DOCTOR'S VIEWPOINT 

who suffers from agoraphobia craves to be near, not 
necessarily trees, but some vertical protective structure; 
in going about an open square he actually hugs the 
sides of buildings ; with a stout cane in hand or with 
a companion he is not so fearful. Then there is ailuro- 
phobia, the fear of cats, which a cousin of Dr. Weir 
Mitchell suffered; the cat might be invisible to him, in 
the next room perhaps ; but he could not stand for it 
to be in the same house with him. Also there is ochlo- 
phobia, the fear of the stare, which seems to be a 
phenomenon not rare in Germany. It is inflicted upon 
those who inadvertently cross gentlemen in the military 
way. I have, fortunately for me, not as yet experienced 
the insistent, horrendous, glassy stare of the Berlin 
Herr Lieutenant ; but I am informed the Krupp works 
do not turn out a more paralyzing weapon. And how 
many, not otherwise lacking in courage, have shrivelled 
before the Gorgonian British 'who the devil are you 
you' stare. These are but a few of many phobias." 

The host had left the room for a moment, and was 
now returned with a book from the library. "We were 
mentioning the timid speaker; as to that here is some- 
thing from Carlyle. And he read : 

"The speaker is as the ass whom you took and cast 
headlong into the water. The water at first threatens 
to swallow him, but he finds to his astonishment that 
lie can swim therein, that it is buoyant and bears him 
along. One sole condition is indispensable — audacity, 
vulgarly called impudence. Our donkey must commit 
himself to his water element, in free daring strike forth 
his four limbs from him. Then shall he not drown and 
sink, but shoot gloriously forth and swim, to the ad- 
miration of the bystanders. The ass, safe landed on 
the other bank, shakes his rough hide, wonderstruck 



THE COWARDICE OF BRAVE MEN 73 

himself at the faculty that lay in him, and waves joy- 
fully his long ears. So, too, the speaker." 

The West Pointer evidently had something in his 
system that he wanted to get out. Presently it came 
this wise: "At the time of the Boxer rebellion there 
was at the legation in Pekin a young lady I had pre- 
viously met in Washington, and who has since become 
my wife. Whilst our forces were in Tien Tzin you may 
imagine my only fear was lest we should be too late ; and 
I am sure that with my last breath I shall bless my 
commander for having told the generals in council they 
might wait if they would, but that for his part he was 
determined the American troops should advance at once 
upon their business of rescue." 

When the tributory glasses had been drained, the 
Baron, who had thus far listened much and said noth- 
ing, was appealed to. This Baron, venerable, his hair 
and pointed beard grizzled, his back straight as a ram- 
rod, monocled, was a gentleman living, in the twentieth 
century, the Henry of Navarre traditions. An incident 
will illustrate the rare type: On the Baron arriving in 
New York a slick American, who had scraped his ac- 
quaintance, borrowed of him two hundred dollars, to 
be returned on an arranged date. When the time came 
the borrower having failed, the Baron being himself 
pressed, reminded him of the obligation. "Have you a 
note?" asked the borrower. "Why, no," returned the 
Baron, "this is an affair of honor, not of business." 
Whereat the borrower told the Baron he might whistle 
for his money, or words of that tenor. A friend who 
knew of this then observed by way of sympathy that if 
this had been the time of the Fourth Henry the Baron 
would have run the swindler through. "No, indeed!" 



74 A DOCTOR'S VIEWPOINT 

rejoined the Baron; "but my lackey should assuredly 
have flayed him!" 

Well, the Baron now spoke: "In the heat of battle 
the soldier knows not fear. Indeed, he welcomes with 
passionate ardor the wild charge. Here is not so much 
calm courage which is in evidence, but rather the re- 
version to primitive and basic blood frenzy, in which 
fear has no place. It is when death cannot be antici- 
pated, coming upon one vaguely, from a quarter one 
knows not where, that the fear of it affects the bravest. 
For instance, when I was a cavalry officer in the Seventy 
war, my fellows and I would be encircling a camp fire; 
we would be smoking, chatting and sipping our coffee, 
when suddednly the blood of one among us would be 
spattered upon his coffee cup and his quivering body 
would fall prone, stricken by a cowardly sharpshooter's 
bullet. There were no braver men than we ; but at such 
times there were none among us whose faces were not 
blanched with fear. No, my comrades (that was his 
term for all worthy men), the thing one feels under 
such stress is not what you call nervousness ; many mili- 
tary men say it is that. But it is the duty of the sol- 
dier first of all to be truthful ; let us then use the right 
word. In such moments there comes upon the hardiest 
a great fear of death, of dissolution, of annihilation." 

"I am thinking, said the doctor, "of a case of seren- 
est heroism in which fear had no part, of calm antici- 
pation of certain death, the moment of which could 
not, however, be assured. There walked into the hos- 
pital where I serve a negro, not much over thirty, hav- 
ing the soft, musical voice of his people, a smile that 
would make you, knowing his sure fate, choke to see, 
and an ashy-gray hue upon his dark face. He bared 
his breast, from which a tumor protruded the size of 



THE COWARDICE OF BRAVE MEN 75 

a cocoanut cut in half; the sharp, stabbing pain of 
which he complained indicated how the aneurism was 
eating through his ribs and breastbone ; the veins about 
his chest were engorged; one could see the heaving ex- 
pansive pulsation; the humming bruit could be heard 
as well as felt. He was at once put to bed, where good 
physicians and kindly nurses could be with him con- 
stantly. I was relieved he did not ask me what his 
chances were; indeed he knew as well as I as to that. 
Next day I visited him. His wife had come with a 
prattling picanniny who was trying to play with him, 
and could not understand why it was being thwarted 
and held back. But sitting up had been absolutely in- 
terdicted the father for fear of a strain ; and the mother 
had to suppress this absurd little creature as best she 
could. I had never quite known the meaning of the 
word resignation until, in these circumstances, I con- 
templated the quiet, yearning face of this suffering 
negro. A few nights after, while a nurse was watching 
him, he suddenly gasped, his whole body was gripped 
for a moment in a mighty convulsion, and then he 
turned flaccid upon his back. The death was merciful ; 
for the aneurism had ruptured while he slept. 

And then they joined the ladies, one of whom was 
extolling a society formed by elderly maiden ladies for 
the protection of cats ; so that wicked small boys might 
not hurt their felines ; and by way of conservation 
against those cruel doctors, who were vivisecting cats 
under the base pr^ence of benefiting humankind ! 



WOMAN'S SEVEN AGES. 

Everyone knows all about Shakespeare's "Seven Ages 
of Man" speech in that most entrancing of all humai* 
comedies, wherein Orlando vanquished more than his 
enemies, as Rosalind so exquisitely admitted. But, far 
as I know, the seven ages of woman have not yet been 
written up. And I am going to make a try at the 
theme, after Shakespeare — a long way after The Thou- 
sand-Souled. And from the doctor's viewpoint. 

The first age of woman is of course that of the girl 
baby. Naturally the best thing about any baby is to 
be well born — eugenized, we would say nowadays. Not 
necessarily of blue blood (which, in the physical sense 
at least, is impure blood) , but fine-minded and fine-bod- 
ied, no matter whether the spoon in the mouth be of 
silver or of pewter. And as a matter of fact most of 
us are well born. You may recall Dr. Oliver Wendell 
Holmes' bull that "one should be careful in the selection 
of one's ancestors." Of course there can be no choice 
here ; and equally of course most of us couldn't imagine 
a better parentage than the one we are blessed with. 
After all only a small minority are not as well born 
as might be desirable. There are children born with 
dreadful disease tendencies, even with diseases — a sad 
heritage indeed. And yet for even these the right en- 
vironment and the right care after birth are a wonderful 
rectifier. Some indeed would say, with Ko-Ko, that 

76 



WOMAN'S SEVEN AGES 77 

heredity "has nothing at all to do with the case," that 
environment is everything ; but they are extremists, for 
a good heredity is not to be decried. 

And here comes the factor of imitation. I talked 
recently with an orthodontist — one of those tooth- 
straighteners. He was for having it that heredity has 
very little to do with queer features and homely jaws 
and crooked teeth. I reminded him that families through 
many generations are known to have family character- 
istics — the famous Habsburg chin, for example, which 
is as typical in the present King of Spain as it was in 
Philip the Second several centuries ago. There is a 
book on that subject which gives many portraits of 
men and women in that Habsburg family, every one of 
them big-chinned. But my jaw-manipulator friend 
rejoined that my instance proved nothing, that imita- 
tion was here at work, and not heredity. What infant, 
seeing big-chinned people about it, would not exercise 
its basic faculty of imitation, would not be constantly 
working its plastic baby chin, so as to have it corre- 
spond with the biologic chin-scheme constantly pre- 
sented for its observation and becoming part and par- 
cel of its experience. Give a baby a bull dog for a 
companion, and it will sit for hours trying to imitate 
the ugly jaw of its pet. The same with the Teddy- 
bear, which is so perverse a substitute for the girl baby's 
doll. May not that child in time look bear-like and act 
so, too, becoming afterward an unbearable woman, of 
the sort a trifle too frequent nowadays. 

Well, if my orthodentist friend is right as to facial 
expression, may not his view be equally valid for the 
thousand and one things babies are supposed to be 
born with. Recall the vaudeville joke. Says Jones: "I 
have a lovely baby; folks say it looks just like me." 



78 A DOCTOR'S VIEWPOINT 

Rejoins Smith: "Oh, I shouldn't worry; maybe she'll 
outgrow it." 

And as to the science of eugenics. It is a science 
which promises to do a lot of good. But remember 
that nature devised eugenics long before our time. Dar- 
win expressed this universal phenomenon in his law of 
the survival of the fittest. By far the most of our 
parents have mated well, simply because they have fallen 
helplessly in love with one another, under nature's won- 
derful and generally benignant influence. "Falling in 
love" is a beautiful and romantic phrase, the scientific 
equivalent of which is natural selection. We are now 
having eugenics contests, "for better babies," which, 
as a newspaper headline puts it, are "picked for their 
brawn." There are "perfect scores" prepared, the 
items being height, weight, circumference of chest and 
abdomen, shape of ears, bones of skull, cheek limbs, 
feet, quality of muscles, and so on. The whole reads 
like these pugilism schedules prepared for the bettor 
who may thus be put in a position to know whether to 
put his money on the Harlem Spider or the Bowery 
Coffee-cooler. In the baby score before me only six 
per cent, is for disposition and ten per cent, for facial 
expression. That is to say, the psychic factor in eugen- 
ics is here greatly minimized. For my part I maintain 
the psychic — the spiritual factor is pretty much the 
whole thing. The test of good birth in a child is the 
noble souls of its parents; that obtaining, the right 
physique will pretty generally follow. I believe such 
sentiments as this of Elizabethan Spencer ought to be 
hammered into people these materialistic days : 

"For of the soul the body form doth take, 
Since soul is form ; and doth the body make." 



WOMAN'S SEVEN AGES 79 



II. 



"Give a child in my keeping up its sixth year; and 
though you may then take it from me forever, and I 
may never see its face again, it will yet throughout its 
life abide steadfast by the training I have given it." If 
the religious teacher who spoke thus had doubled this 
formative period, it would surely not depart from the 
path laid out for it in that dozen years. I believe the 
principle is tremendous, and most important of con- 
sideration in this twentieth century chaos of a civiliza- 
tion, when all evil is supposed to be avoided and rec- 
tified by means of laws rather than through reverence 
for the home and the family ideal. The first dozen years 
are the most impressionable in existence; which means 
that the child's destiny is developed nowhere else than 
in the home; and that it were well-nigh hopeless to 
assure its right development anywhere else. 

Of course the school and the religious teacher must 
play their adjuvant part. Childhood is the formative 
period, both for mind and body. The ancients were 
insistent on the sane mind in the sound body; and we 
of to-day fully recognize how right they were. It is 
superb, the things that are done nowadays to assure 
the health of our school children. And many of the 
schools that are now building are marvels for healthful- 
ness and sanitation. I have read of a little girl whose 
mother was combing her hair with a rubber comb in the 
gloaming of rather a cool evening; there came sparks 
from those curls in the process. She asked her mother 
how those sparks came. And her mother answered that 
they were electricity from her hair. "That's funny," 



80 A DOCTOR'S VIEWPOINT 

she observed, "here I've got electricity in my hair, and 
grandma's got gas in her stomach." We have cer- 
tainly got past the gas age mature people remember; 
and into a very truly electric age in education. (By 
the way, they have even been talking of electrifying 
school children at their studies, by having currents in 
the walls of the school room ; they might better electro- 
cute them than do that.) 

It is essential to develop the child's imagination or 
at least to educate and direct this faculty to the end 
that the ideal shall ever be for it the real in life. Con- 
sider how rich it makes the child; it doesn't have to 
have millions, for it will then enjoy all that millions 
can bring — and much more. The wonderful books that 
are written for children, the fairy tales, the flowers in 
our parks, the folk dancing (in Hellas dancing, besides 
being a pleasure, was so important a factor in life that 
it was a part of religious service), the calesthenics chil- 
dren go through, the exquisite poise and sense of form 
and rhythm which are got from the music of the old 
masters (Papa Haydn and the child-natured Mozart), 
seeing the comedies of Shakespeare and others (by 
which many a tenement little girl acquires the charm 
and graces of a gentlewoman). What matter limed 
walls, kitchen chairs and pressed crockery to the child 
that can by imagination acquire taste and a gentle- 
womanly disposition. Lafcadio Hearn gave us his ex- 
quisite presentments of Japanese life before he visited 
that land; it was mostly in his imagination any way, 
for he could see with his physical eye almost not at all, 
poor fellow! And the Laird in "Trilby" painted su- 
perb pictures of Arabian life out of his imagination; 
but after he visited Algiers and really saw these places 
his pictures of them were atrocious. How pauce are 



WOMAN'S SEVEN AGES 81 

oftentimes real things by comparison with the ideals of 
them that are cherished. 

Ill 

There are two paintings I long ago, in my mind's 
eye, placed side by side, by reason that they glorify 
each a complemental phase in human life — man's and 
woman's third stage. They are both very familiar pic- 
ture; and the reader will at once recognize my sketch 
of them. They have to do with early manhood ("the 
lover sighing like furnace") and maidenhood, when 
poetry, music, flowers, perfumes, sunshine and the 
theretofore latent instint to love and power to inspire 
love are gloriously dominant; when sentiments ring 
true; when there is (as yet) never a thought of subordi- 
nating ideals to considerations of worldly interest. 

The one of these pictures is called "The Soul's Awak- 
ening." I don't know whether Zant, the painter, named 
it thus. Perhaps it is in this respect like the moon- 
light sonata or the Spring Song, to neither of which 
Beethoven or Mendelssohn gave those titles. Anyway 
Zant's painting is to my mind wonderfully well entitled. 
We see a very young girl, whose family and friends 
have but a little while before been done with speaking 
of her as a child ; she is now a woman, but she has thus 
far hardly passed through the gateway into that mar- 
velous field. Its strangeness and its wonders are very 
new to her and very entrancing. Clearly she has en- 
tered on ways most lovely, such a field as she dreamed 
of in childhood; in her little-girl day musings there 
have been vague foreshadowings of its beauty and its 
comfortableness. But her dreams never reached the 
realization now vouchsafed her. 



82 A DOCTOR'S VIEWPOINT 

Yet even with her still tremulous hand (tremulous 
as the body of a little bird) on the gate, she can com- 
prehend that in all things good and pleasurable there 
must come responsibilities and cares as yet uncompre- 
hended. And although she has no fear, courageous 
emotions are certainly aroused in her. And now too, 
she finds the life into which she has come to be stim- 
ulative of faith and truth in the Power that has pre- 
pared and ordered this field for her indwelling through- 
out the remainder of her existence. 

In Zant's epic portrayal the courage and the trust 
lie mostly in the eyes, which are large and clear and 
liquid and deep and very frank; in them all the fear- 
lessness that will be needed are to be found. Then be- 
sides the eyes, that superb painter has presented a most 
ingratiating and winsome face, and this with infinitely 
gentle touch. And the as yet immature figure is ex- 
quisitely portrayed; and last of all the luxuriant hair 
caressing tenderly the head and the shoulders. What 
poet's heart this Zant must have; and what a veritable 
seer he must be, to be able to grasp as he does the 
innermost, the fundamental in life. 

The other paintings in my mind is Abbey's Sir Gala- 
had, whose ideal was 

"To love one maid only, cleave to her, 
And worship her by years of noble deeds." 

But this, as Kipling would say, is another story, not 
here to be dilated on. 

IV 

For this stage Shakespeare represented man as "seek- 
ing the bubble reputation, even at the cannon's mouth ;" 
he comes now upon the time to fight the world's battles 



WOMAN'S SEVEN AGES 88 

(how futile so many of them are), to do the world's 
work. For the woman it is the time of wifehood and 
motherhood; and hers is indeed the harder part. The 
life of man is glory, the life of woman is love. 

"For men must work, and women must weep, 
Thus runs the world away." 

And here, quite absurdly, a practical idea enters my 
matter of fact, professional head; it is a descent in- 
deed, from the sublime to the ridiculous : The most 
important thing for bringing babies triumphantly to 
weaning is the right kind of milk; if they get that 
their tummies won't be behaving so badly (mewling and 
so on, in the nurse's arms, as Shakespeare graphically 
but rather inelegantly put it.) The best kind of in- 
fant's food is that which is drawn form its dear moth- 
er's breast; practically all the digestive disturbances 
of infancy (oftentimes fatal as they are) do not trou- 
ble breast fed infants. Of course some mothers are in- 
capacitated by illness or weakness from giving their 
babies this natural nutriment; and, sad to tell, there 
are some mothers so rebellious of this blessed function 
that they consider the demands of fashion and of so- 
ciety superior to it, worthier and paramount. Thus, 
for one reason or another, many babies have to be 
bottle fed; so that the science of infant feeding by 
modified cow's milk has been developed. 

And here is a grotesque notion. Next after the am- 
bition to portray adequately the countenance of The 
Christ the painter has striven to present The Madonna 
and Her Child. In the former essay almost all have 
failed, in the latter not a few have succeeded. And we 
have many beautiful, sympathetic and precious can- 
vasses and marbles of the mother and her infant. But 



84 A DOCTOR'S VIEWPOINT 

what would you think of a madonna, instead of giving 
her sacred breast, pictured as feeding her babe out of 
a bottle labeled "percentaged, lime-water, Pasteurized 
cow's milk!" 

A mother who fed her baby thus (perhaps through 
no fault of her own) or had the nurse to do it in her 
stead, bewailed her baby's death to a great physician; 
"it had pleased Providence," she said, "to take her baby 
from her." The doctor told her she had no right lay- 
ing the fault on Providence, Providence had had 
nothing at all to do with the matter. It was bad milk 
that killed her infant — bad milk, for which humankind 
and not the Deity, is blameworthy. 

And now about another picture. Everybody has 
seen it in print shops. It represents a young mother of 
the poor, clad in a cheap shawl, weeping over the corpse 
of her first born. I have seen that picture in the very 
life — and death; and the memory sometimes haunts me. 
It was in a squalid tenement. There was nothing in 
the room save a kitchen table on which the dead baby 
lay, and the rickety chair in which the mother sat. Ab- 
solutely nothing else ; it looked like an eviction for rent 
unpaid — though I don't know as to that. 

I had knocked several times at the door, and had 
received no answer. Then I went in. Just as in the 
picture sat the mother, hugging that rigid little body, 
with its baby head so endearingly shaped; constantly 
kissing its thin waxen hands ; crying convulsively, so 
that the tears kept running down her checks ; whilst she 
talked to, even crooned to, the little creature she had 
borne and had so willingly suffered for; cuddling it to 
her breast and begging it to smile the way she had 
coaxed it to in life; doing the things mothers love to 
do with their infants. All the tragedies of the ancient 



WOMAN'S SEVEN AGES 85 

Greeks, and all others imagined since, paled after that 
one before me, whilst I stood speechless and reverential 
and — to speak truthfully — frightened. For here wag, 
the most awful, the most epic, the profoundest of all 
human tragedies. 

V. 

We come now to what is in man really the noblest 
and superbest age — that of his maturity. For women 
it is no less noble than any other; but as certainly it 
is the most difficult of them all. 

I once knew, professionally in the beginning, a lady 
who believed in mind cure; and the reason she wanted 
my ministrations and my prescriptions was that she was 
not then so strong in faith as she was going to be later. 
It was only a matter of time when her faith would be- 
come so strong that she would not need doctors and 
medicines. She had had, before calling on me, a nervous 
affection. Several years ago she lived in a low-lying 
city by a vast body of water ; her doctor there advised 
her to go for relief into a dry equable climate of some 
altitude. This she did and soon became well. Shortly 
after her arrival there she came upon some Christian 
Scientists who interested her in their cult — and pres- 
ently began to attribute her return to health to their 
influence ; finally she became one of them. Soon after- 
wards she came to New York to live; in this trying 
climate her symptoms returned and were not alleviated 
by the "healers." She then dropped that cult for 
reasons which need not here be detailed. Then she took 
up theosophy, in which she presently found some ob- 
jectionable features. Following upon this she took 
up and in turn discarded mental science, spiritualism, 



86 A DOCTOR'S VIEWPOINT 

new thought, and what not else. On the occasion of 
her last call on me she began very buoyantly to enter- 
tain me with an account of a "splendid" lecture she had 
attended by one "Professor" Blank. This lecture had 
so appealed to her that she had decided to attend a 
course which had been arranged ; and had already paid 
in advance — as required. 

Now, according to the professor, everything goes by 
vibrations. The explanation of the nature of these vi- 
brations seems to have been omitted from that precious 
course of lectures. Health and happiness lay entirely 
in keeping harmonious with these vibrations; and by 
the end of the course the way how to achieve this har- 
mony would dawn in fullest illumination upon you. It 
was explained in the first lecture that the lecturer had 
himself been a Christian Scientist, a new thoughter, and 
an adherent of several other like systems ; but one after 
another they had seemed so strange and eccentric and 
unrasonable (amazing how your Paracelsian loves that 
word), that one after the other he had lost faith in 
them. But now he had himself, through prolonged Nir- 
vana-like abstraction, come upon the right idea. He 
was the man for your money (though he didn't of course 
put it that way) ; and if you valued health or happiness 
you were by all means to keep clear of that shop across 
the way, or any other. 

Now all this seemed, in that poor lady's narration, 
so absurd to me that my face presently broadened into 
a smile — which was at once checked by her saying very 
piteously : "Why, oh why are you laughing at me?" And 
then she fell to weeping. 

Indeed, and in very truth, it was no laughing matter. 
She surely felt conscious of a lack of dignity and of 
normal womanliness; her nature must have been per- 



WOMAN'S SEVEN AGES 87 

meated (subconsciously no doubt, except at such mo- 
ments as this), with the knowledge that her philosophy 
of life was absurd. But she had now come to be like 
a man that had been fighting continuously against the 
unfairest kind of odds; knocked down, he jumps up to 
continue the struggle, and is again worsted ; after many 
such encounters a sort of inertia is inevitable by which 
no kind of fight can be put up as obtained in the be- 
ginning. And so this gentlewoman had now come to 
be afflicted with a psychic inertia, which rendered her 
incapable of rising above and freeing herself of abnor- 
malities. The whole trouble probably originated like 
this : She was past forty and she had not married. Now, 
there are many superb women who have not married, 
and for reasons all sufficient for them. But this does 
not obviate the fact that such singleness is not the best 
state at all, but is the greatest pity in the universe. 
As for my poor friend, she was extremely charming; 
and if any woman had ever been born for wifehood it 
was she. Had she so elected she would have made some 
one among the many she had known a hopeless, irretriev- 
able optimist for the rest of his days. She had chosen 
instead to be a "bachelor girl," like so many foolish 
women nowadays ; she had deliberately set aside her man- 
ifest destiny. And what kind of a miserable alterna- 
tive was hers ! 

I have written at greater length than I had intended ; 
and can only in a few words state that in this example 
is to be found the germ of so much of the chaos in 
which we are existing (not living at all) these days. 
Herein is to be found the genesis of the suffragette, 
the feministe, the man hater, the divorcee, the woman 
who would rather pet animals than love children, she 
who so ineptly rails at fate, the female Prometheus. 



88 A DOCTOR'S VIEWPOINT 

It is a dreadful thing indeed how frequently the ideal 
of the family and of the home which are the founda- 
tion and the keystone of all civilization, of all refine- 
ments, of all human relations, of all hopes, of human 
advancement from savagery, should be most subverted 
by those who ought, for their own security, to be the 
most jealous supporters of this ideal. 

And as for mere man; why, bless you, that sex isn't 
nearly so bad as it seems. It certainly doesn't deserve 
to have its face scratched — leastwise, not as a sex. 

VI 

In my youth I had the blessing good fortune to know 
an elderly gentlewoman, now since gone to her sure 
reward. It would be difficult to imagine anybody more 
necessary to her kin, her friends, or to the community 
in which she lived. No family matter, whether the en- 
gagement of a granddaughter, or the starting in busi- 
ness of the boy of him who had married her niece's hus- 
band's second cousin, was ever concluded without her 
interest being solicited. Any friend who had ever sat 
at her table or had drunk a cup of tea under her roof, 
might claim consideration almost as warm as for those 
actually of the blood, or who had married into it. And 
a made man was that tradesman who could deliver his 
goods at her basement door. Her home, I must be 
careful to add, was in that elysium about Washington 
Square Park, in the Metropolis. 

Now, ordinarily, people are apt to drop in to tea 
of Sunday evenings — high tea — and welcome. But this 
dear lady had high tea every evening. Youngsters 
would come in the late afternoon, and have their heart- 



WOMAN'S SEVEN AGES 89 

agonies soothed by her. And girls would "just drop 
in" and be amazed to find there sundry boys whom they 
could never have imagined would happen there precise- 
ly at that time — oh, dear no ! The old, the young, men 
and women, with little children, would call; and gen- 
erally would stay to tea. The men who came seemed 
to appear from all over the habitable globe. She was the 
widow of an Englishman who had been in the navy; 
wherefore men who had travelled much were to be 
seen there. And certainly no one of them who ever 
touched at the port of New York would dream of miss- 
ing this snug haven. And what extraordinary little 
presents they were constantly bringing; the house 
seemed full of them: Tea, made of real tea leaves, from 
China ; horrendous Japanese idols ; amulets from India ; 
perfumes from Araby; laces from Ireland; flowers al- 
ways. 

Truly you thought of Browning's tender bit of flat- 
tery that "the young women are beautiful, but the old 
women are still more beautiful," when you were in the 
presence of this genial, satisfied, satisfying hostess ; 
seated at the head of her mahogany ; clad simply in am- 
ply-draped, soft black silk, with old lace about the 
neck and at the wrists, the dress slightly opened at the 
neck and filled in with that fluffy kind of stuff which I 
understand is called tulle, an old time brooch (some 
family heirloom) pinned to and resting upon it. 

No table cloth on the mahogany, of course; but su- 
perb silver, sparkling glass and wonderful chinaware, 
with a bowl of flowers in the centre of that polished 
wood. Your moral tone (I speak of course only of 
men) was jacked up many a peg, whilst you masticated 
veal loaf and salad, home made preserves and cake ; and 
you imbibed of the cup that cheers, conversing through- 



90 A DOCTOR'S VIEWPOINT 

out with the fortunate company gathered there, in the 
benign effulgence radiating from the head of the table. 
Lagging superfluous on the stage? Well, hardly. 
Ah, how we have since been missing her! 

VII. 

"Last scene of all," the justified mother of men, who 
rests in her armchair on the porch, surrounded by her 
comforting children and her children's children, whilst 
the rays of the setting sun touch warmly her whitened 
hair. Serene she sits, her eyes steadfast upon the west- 
erly glow, as the twilight gathers, and the evening star 
appears, musing of many things in the past, but mostly 
of memorials dearly treasures and fondly laid aside in 

some old cabinet. 
V J ' 
"Her hallowed bridal dress, 

Her little dainty gloves, 

Her withered flowers, her faded tress." 

Brillat-Savarin had an aunt with whom he felt a mu- 
tual and very warm affection. When past her ninetieth 
year he was summoned to her bedside. He brought 
with him some of his best and most restorative wine. He 
most gently raised her head and induced her to take 
some of this good wine. She thanked him, and sinking 
back contentedly on her pillow, said to him, "My dear, 
should you come to my years, you will understand that 
the aged need death just as the young need sleep." 



LET US GO OUT INTO THE SUNSHINE 

It seems like harking back to another generation to 
have read that President Finley, of the College of the 
City of New York, did his thirty miles in nine hours — 
in the night time, too, when pretty much everybody 
was asleep. He began his jaunt with Elizabeth, New 
Jersey, and ended up in Princeton for breakfast. A 
fine example for his students ; and one that could have 
been set only by a man sound in body and mind; one 
much too rare in these days of trolleys and motors. 

Samuel Johnson tramped through the Hebrides, for 
all his scrofula. OUie Goldsmith was for years a way- 
farer throughout Europe. Mark Twain tramped 
abroad — whenever he couldn't "get a hitch" or take a 
boat. Blaikie, in his immortal book on "How to Get 
Strong and How to Stay So," in the last of many 
editions, as well as in the first, maintained the best of 
all exercises to be walking. 

"Give me," enthused Hazlitt, "the clear, blue sky 
over my head, and the green turf beneath my feet, a 
winding road before me and a three hours' march; and 
then to thinking." Whereat Stevenson : "And he must 
have a winding road, the epicure." Poor, sick Robert 
Louis, who could appreciate, but could not enjoy, such 
gratification. 

In other generations men thought nothing of thirty 
miles. For Dickens it would have been just a freshener, 
a regular morning exercise — just one hearty meal of 

91 



92 A DOCTOR'S VIEWPOINT 

fresh air. Lily Langtry, in her prime, frequently did 
her twenty miles a day; no wonder she was handsome. 

Nor is that wonderful old bishop to be forgotten 
who died now some two years ago, at three score and 
ten; and who regularly spent a fortnight's vacation 
for many years in tramping — through the Shenandoah 
valley one summer, somewhere in Virginia the next. He 
loved for a season at least to become a simple wayfarer. 
Being anxious to know intimately his Master's own 
people, he slept at night in the homes of poor work- 
ingmen, got their points of view, sympathized with them, 
mended their clocks (he was amazingly dexterous at 
such handiwork — for a clergyman), admired their pigs, 
and told their children stories. And they, for their 
part, not at all realizing the huge enjoyment and ben- 
efit he was getting out of it all, pitied that poor, old 
white-haired man, with the long, flowing beard, who 
journeyed a- foot, since seemingly he had not the where- 
withal to travel any other way. 

Especially should walking entice those who work 
mostly with their brains. The season is now on. The 
clear sky, the bracing breeze, the rustling boughs, the 
murmuring waters, the birds, their throats simply burst- 
ing with melody — these our brethren, which should be 
our familiars, are calling; let us go forth and walk. 
Select little- frequented roads, as free as possible from 
"devil wagons." 

But take some precautions: Be very careful not to 
overtax the strength in the beginning; in walking as 
in everything else, one must avoid extremes. Radical 
changes are not without danger when abruptly made. 
The desk or the office in the city is an altogether other 
environment than the woods. 



LET US GO OUT INTO THE SUNSHINE 93 



GET WHOLESOMELY TIRED 

In going for a day's walk, on a Sunday or a holiday, 
there is no harm in getting stiff and wholesomely tired ; 
a warm bath at bedtime will set that right. But when 
the trip is to be extensive — as for a fortnight — the 
man-machine must not be overtaxed at the start. No 
more than five miles the first day ; ten the next ; fifteen 
or so the third. And then you may begin at daybreak 
and walk until you are canopied by the stars ; and even 
were that day the twenty-first of June, no harm will 
come of it, but much good and happiness. 

The way to walk is to throw back your shoulders, mil- 
itary fashion — the chest out, the pectorals expanding, 
the nostrils dilated with the fragrance of all outdoors, 
the lips closed, the head erect. The arms to swing half- 
way, not like a windmill. Have your mind diverted by 
the everchanging scenery; there is nothing else that 
will so surely get the cobwebs out of the brain. 

This simple, primeval exercise is preferable to any 
other, in that it is not necessarily in the contestant 
class of athletics. No preparations (except as I have 
stated) are needed to be in prime for it. And in other 
sports — boxing, tennis and the like — what men do not 
become slower in their movements after thirty? Who, 
even the most expert, could, after fifty, think of com- 
peting with young men in them? Nor is there any 
better way than walking tours for middle-aged gentle- 
men to dissipate an undistributed middle, and to restore 
the belt line to its normal. 

Very little paraphernalia is required ; certainly little 
if you are going for the day only. A stout easy pair 
of shoes are essential — such as have been tried out a 



94 A DOCTOR'S VIEWPOINT 

week or so beforehand ; and the feet must be well bathed 
and nursed (vaselined, if necessary) at the end of the 
day, so that they will not be tender. Many a walking 
trip has gone to pieces the first day or two by reason 
of blistered feet. Talcum powder is to be dusted in the 
shoe if there has been perspiration. 

A good wayfarer, who is not too fussy, and of rea- 
sonably democratic tendencies, can find a good lunch- 
ing place anywhere along the road. Some very pleas- 
ant recollections of my own are of my seat on any con- 
venient barrel in the country store, crackers and cheese 
in one hand, a glass of ginger ale or cider in the other ; 
and a discussion of the perversities of our political 
system with the village coterie. Hotels great and 
small, magnificent and modest (the latter generally the 
more comfortable) are never lacking. 

A cake of chocolate in the pocket will never be amiss. 
This is a most sustaining food. I understand that 
German soldiers on forced marches are rationed with 
it. Weston ate often in his walks; an egg beaten up 
in a cup of hot coffee was a favorite refreshment. As 
often as he hungered he ate — I presume a little at a 
time; for such energy as he displayed disposed rapidly 
of tissue waste, which had as rapidly to be replaced. 
That is what we are after in a walking vacation — to re- 
new our bodies, to get rid of the sluggishness stored up 
through months of sedentary occupation; and to get 
rejuvenated, or better still, born again. Throughout 
Weston's last walk from the Atlantic to the Pacific he 
lost but eighteen pounds. And when he felt drowsy he 
ate; and this, he declared, restored him and banished 
sleep. Here, however, the amateur should not imitate 
him. 



LET US GO OUT INTO THE SUNSHINE 95 

As to companions on the walk: A party is usually 
congenial; because if you are bored by one member, 
you can easily find another more in keeping with your 
temperament. In a party you will always find your man 
— of either sex. But if you are to have one companion 
be sure he's agreeable; otherwise there is no torture 
so exquisite as a day's walk in his company. Not only 
does he make you suffer on his own account, but you 
los$ all the other pleasures into the bargain. If you 
are not absolutely sure of your man, go alone; you 
will be Surprised what a good fellow you will then be- 
come acquainted with! Don't wait to get your own 
experience about this; take mine. (This, reader, is 
strictly entre nous; and I had rather it wouldn't go 
further.) Remember that walk which Anstey and an- 
other took on the Cader Idris in Wales? After the 
first hour they began to be bored with each other ; then 
they got offensive, then sardonic, then insulting, and 
finally fit for any crime, as for instance: "Do you 
know why you remind me of this mountain?" said An- 
stey. "No, why?" returned his companion. "Because 
you're a cad awry dressed." 

DISCOVERIES FOR ALL 

Every one will surely find, in a little search, delightful 
walks in his own vicinity. I give you here my own 
discoveries around our greatest of cities. The Metrop- 
olis is supposed by many to be a sort of colossal prison, 
where one is doomed to spend the most of his years in 
canyon-like streets, with never a hope of rural delights. 
Not at all so. Suburban New York has truly Olympian 
happiness for the man who is good for from ten to 
twenty miles before nightfall. Within half an hour's 
ride one might imagine himself in the heart of the Berk- 



96 A DOCTOR'S VIEWPOINT 

shires. In Westchester County there are Grey Oaks, 
Hastings, Scarborough, Dobb's Ferry, Irvington, 
Sleepy Hollow, Tarrytown, to be visited afoot. Walk 
from White Plains to Mt. Kisco; and Central Valley, 
for a longer trip, from Newburg (to which place the 
"Albany Day Boat" takes you) to Suffern. Or from 
Suffern to Greenwood Lake, thence to Lake Hopatcong, 
and back to Suffern, if you like; or from Newburg to 
Port Jervis, thence along down the Delaware to the 
Water Gap and so home; or from Nyack to Rockland 
Lake. For the tramp along the Palisades from Fort 
Lee to Nyack no other word than magnificent is fit; 
and what a climax is that sail across the Tappan Zee 
in the twilight, with the train to take one home in 
the evening! 

Or for an afternoon's outing, take the trolley to 
Prospect Park in Brooklyn ; walk thence along the park 
until you reach the Ocean Driveway ; and so, continuing 
afoot, with the briny air in your face to Coney Island ; 
then, if you are not yet satiated, return by way of 
Cropsey Avenue to Fort Hamilton, and to the Brook- 
lyn end of the 39th Street Ferry. "And so home," as 
Pepys would say. Or take the trolley to Jamaica and 
start in any direction, for Long Beach (this is indeed 
superb), or for Garden City. Or go from Flushing 
to Lawrence and thence to Rockaway, and by trolley 
home. 

But I would give you now the bonne bouche of the 
feast — a week in latter September or early October : I 
boarded the Mary Powell which took me through the 
Hudson in the late afternoon and the twilight to Round- 
out; then I trollied to Kingston where I slept for the 
night. Next morning I returned to Roundout, ferried 
to Rhinecliff and then on my shoes to Pine Plains: — 



LET US GO OUT INTO THE SUNSHINE 97 

twenty miles. More than I should have gone, and 
breaking my own rules. But the air was crisp, the 
road level and excellent and the scenery soul-filling; 
and so I was just porcine that day. Thence after 
breakfast to Lakeville where I lunched; and so on to 
Falls Village, Connecticut, where I lodged with a friend. 
Then began a veritable jog of joy, through the Berk- 
shires to Bennington, Vermont. I trollied back to 
Canaan, Conn. Then I gave a day to a triangle from 
Canaan to Norfolk, and thence over Norfolk moun- 
tain (Helicarnassus, I am sure, has nothing on that 
mountain, nor on the plain below), back to Falls Vil- 
lage, where I revisited my friend for a night. 

I did not know then what hallowed feet had preceded 
mine ; but many years ago, when walking was more the 
vogue — and men brawnier, I can't help thinking — Sen- 
ator Hoar and Horace Gray walked over much of this 
territory. 

I recently discovered the fact in Hoar's Autobiog- 
raphy: "We started from Greenfield and walked over 
the Hoosac Mountain to Adams and Williamstown, then 
over the old road to Pittsfield, then to Stockbridge, 
Great Barrington and the summit of Mt. Washington 
now better known as Mt. Everett or Taghconic ; thence 
to Bashpish Falls in New York, and to the Salisbury 
Lakes in Connecticut." Be sure to get the book and 
read (p. 376 vol. II) what a dream of a time they had, 
how they met Josh Billings, and so on. 

Well, then, leaving my friend at Falls Village, I made 
for Litchfield over Goshen Mountain, to Watertown, 
and so for the last day, by trolley to New Haven and 
along the Sound back to the Metropolis. 



SENSE TRAINING 

To one ambitious of leading the scientific life, sense 
training is from the beginning most essential. "Seeing 
is believing," but the belief thus founded may not be 
rational. Seeing, reviewed and, if necessary, revised by 
the reasoning faculty, will then be soundly based. Only 
from such process can facts be born — facts, the sole 
building material with which science can work. The 
senses are by no means a sure guide ; the very best they 
can do is to appreciate phenomena : that is, appearances. 
The stick appears broken in the pail of water; reason 
assures that it is not. Using a bright spoon for a 
mirror, one appears variously, as he holds the spoon 
inside or outside, or up and down, or sideways; but it 
is to be hoped one does not look any of those ways in 
reality. Cross the middle over the index finger; roll 
their tops over a bread pellet in the palm of the other 
hand, and the sense of touch will convey the impression 
of two pellets ; but reason corrects the impression, and 
convinces us there is but one. Reason must ever bring 
judgment, memory and experience to bear upon the 
perceptions which the senses convey to the cerebrum; 
by these means reason must constantly be rectifying 
false sense. 

It is amazing how frequently the imagination plays 
fast and loose with the sense functions — delusions, il- 
lusions and hallucinations being the result. Le Bon, in 
his fascinating book "The Crowd, a Study of the Pop- 
ular Mind," tells of a crew shipwrecked upon a raft, 

98 



SENSE TRAINING 99 

who kept eagerly scanning the horizon for a sail. After 
some days of watching one of these poor men, his 
psychism perturbed by his sufferings, being obsessed 
through desiring to see a rescuing ship, unquestionably 
saw something; and so desperate was the hope of his 
companions, that one and all agreed with him that 
the thing he pointed out was a vessel which could rescue 
them. When they came upon it, however, they found it 
but a tree which had evidently been uprooted and had 
gone adrift in an equatorial storm. Tuke, in his admir- 
able book "The Influence of the Mind on the Body," 
relates how a boy who had on an afternoon seen a 
hanging, which had naturally much affected him, took 
a stroll along a country road in the evening of that 
dreadful day. He presently saw projected against the 
moon-lit sky the gibbet of the afternoon, and the crim- 
inal suspended from it. He ran home dreadfully fright- 
ened, to find that a cord dangling over the brim of his 
hat had by his overwrought imagination been meta- 
morphosed into the aerial gallows. 

Every reader will recall how he has in like manner 
been tricked by his senses. Hundreds of instances might 
be cited of delusions entertained by the unscientific, the 
unsophisticated, the highly emotional; people in whom 
such aberrations are not without excuse. We who pride 
ourselves upon our attainments in science are so prone 
to consider such delusions the exclusive property of 
geniuses, spiritualists, theosophists and other people 
whose imaginations tend to work overtime, that we feel 
distinctly humiliated to learn how men even eminent 
in science have been the victims of psychic perturba- 
tions. As, for instance, when the telephone was in- 
vented, a lecturer who was giving a public exhibition 
of the apparatus clearly and repeatedly heard the notes 



100 A DOCTOR'S VIEWPOINT 

of a trumpet which he had arranged to be played at 
the other end. He declared that he heard ; nor need the 
record be doubted. Yet none of his audience could 
hear the trumpet; and for the all-sufficient reason that 
the trumpeter had made a mistake in the day, and was 
not in his place at all. 

A very modern instance of "illusion caused by a spe- 
cies of auto-suggestion based on preconcerted ideas," 
is furnished by the episode of the N-rays, which all com- 
petent men now agree never had any existence at all. 
Professor Blondlot believed (in good faith, of course), 
that he discovered these rays at Nancy in 1903. He 
described them before the French Academy of Sciences, 
which body gave him a gold medal for his discovery. 

Up to 1906, there were published one hundred and 
seventy-six original papers concerning these rays. 
Blondlot's observations were in turn confirmed by such 
well-known physicists as Charpentier and Becquerel. 
The N-rays were considered to be given off by almost 
all substances when in a state of strain ; a tempered 
steel bar, Nernst lamp, and even a human nerve and 
muscle would emit them. The rather fanciful sugges- 
tion was advanced that if a certain radiation were given 
off by our bodies, according to their degree of activity, 
our thoughts might possibly be photographed: 
"thoughts being only brain rays." ( Of course, the 
work within the last year of Drs. Kilner and Fielkin 
in London, as to the photographing of the "atmosphere" 
or the "aura" which the human body is considered to 
exhale, springs at once to mind.) 

The N-rays, stated French investigators, could be 
reduced or removed by anaesthetics ; a tempered steel 
bar, for that matter, could be chloroformed into quies- 
cence. Following upon this the invitation came natural- 



SENSE TRAINING 101 

ly enough to men of science "to revise some of our 
notions on the difference between the organic and the 
inorganic." The N-rays were held to be even more 
wonderful than the X-rays or radium. Oddly enough, 
however, the N-rays did not, like the X-rays, affect 
either the spectroscope or photographic plates. Ad- 
mittedly they were rather baffling and elusive, at least 
to those inexperienced in detecting them; but they had 
one physical effect upon which experimenters relied — 
their powers to intensify a light. A marked increase 
of luminosity was considered to be perceptible when 
an N-ray was directed upon a spark; or if a bar of 
tempered steel were held near a clock in a dark room, 
it was supposed to be possible to read the time. 

As the months rolled by Blondlot's experiments were 
confirmed, and were even extended outside France. Yet 
many scientific men utterly failed from the first to ob- 
serve any of the phenomena described. English and 
German investigators became particularly sceptical; 
and rather absurdly a dispute arose which, by the law 
of the crescendo in psychology, accrued progressively 
as to bitterness; compliments increased in warmth as 
they lost in polish. Things became quite akin to the 
immortal "Row upon the Stanislaus." Two camps were 
formed — the Latin and the Teutonic. The French im- 
puted racial prejudice and animosity to their foreign 
critics. It was suggested that the rays could be dis- 
tinguished only by the more sensitive and finer-fibred 
brain of the Latin ; whilst what, sacre bleu! could be ex- 
pected of the fog-muddled British brain, or of the beer- 
befuddled German psychism! The matter in dispute 
threatened to place itself beyond the bounds of any 
reasonable demonstration. Presently, however, the cool- 
est French scientific men gradually came to suspect 



102 A DOCTOR'S VIEWPOINT 

that if no results could really be obtained in England 
or Germany, the explanation of the French experiments 
must be subjective and psychological rather than ob- 
jective and physical. 

Finally, the Revue Scientifique settled the question in 
a very simple way. It was proposed that several boxes 
of exactly similar appearance, some containing pieces 
of lead, others of tempered steel, should be sealed ; and 
Blondlot or his assistants were to decide which of the 
boxes contained the active material. Blondlot refused 
this test, saying that "the phenomena were far too 
delicate for such a trial" ; and he left "everyone to his 
own opinion on the N-rays, either from his own experi- 
ments, or from his confidence in others." Thus was 
the dispute transferred from the realm of fact to that 
of opinion, experimentation ceased, and so far as sci- 
ence is concerned the incident was closed. 

Such incidents as these are rather humiliating to the 
scientific temperament, which, nowadays, is just a trifle 
inclined to self-satisfaction. Fortunately, they are ex- 
tremely rare. Science is knowing; good science is ever 
certainty grounded upon demonstration. To this end 
the pre-requisite is the trained senses. Science's vo- 
taries, moreover, if they are to serve her well, must 
ever be free of auto-suggestions and haphazard con- 
jectures incapable of verification. 



EUGENICS 

Francis Galton, the founder of eugenics, which he 
defined as "the study of the agencies under social con- 
trol that may improve or impair the racial qualities 
of future generations, either physically or mentally," 
was himself singularly fortunate, both in his own hered- 
ity and in his way of life. The Galtons have been a 
superb Quaker stock through many generations ; the 
grandmother of Francis was a descendent of Barclay, 
the apologist ; Charles Darwin was his cousin ; his moth- 
er, two brothers and two sisters at least, were nono- 
genations. At eighty-six he wrote : "I find old age thus 
far to be a very happy time on the condition of sub- 
mitting frankly to its many limitations." The quota- 
tion is from Memoirs of My Life (Dutton), one of the 
most content-diffusing books in existence. (A digres- 
sive ancedote is irresistable. During an exploring 
expedition in Southwest Africa Galton visited 
the Ovampas. "I did much to make myself agreeable, 
investing King Nangoro with a big theatrical crown 
that I had bought in Drury Lane for some such pur- 
pose ; but I have reason to believe that I deeply wounded 
his pride by rejecting the present he offered in re- 
turn. His niece appeared in my tent, raddled with 
red ochre and butter, and as capable of leaving a mark 
on anything she touched as a well-inked printer's roller. 
I was dressed in my own well-pressed suit of white linen ; 
so I had her ejected with scant ceremony.") These 
memoirs tell of an astonishing number of talented rela- 
tives continuing to the present generation, that of 

103 



104. A DOCTOR'S VIEWPOINT 

Galton's grandchildren. His own psychic gifts were 
of the superlative order; his mental acumen was amaz- 
ing, his vision extraordinarily broad. And his marriage 
was most haply, into a family hardly less remarkably 
than his own — the Butlers. And he naively wrote (pre- 
sumably sometime after the honeymoon) : "I protest 
against the opinion of those sentimental people who 
think that marriage concerns only the principles." Thus 
were his lines cast ever among all that has been and is 
best in English life. His fortune was altogether ample 
for the needs of so well-poised and philosophical a man. 
Especially did he enjoy association with the finest tem- 
peraments of his day — Maine, Kay, Hallam, Tom Tay- 
lor, Tom Hughes, Spencer, Huxley, Faraday, Tyndall, 
Gladstone, Burton, Pollack and scores of others. 

It were difficult withal to conceive a man more sat- 
urated with loving kindness, more solicitous for human 
welfare; and this, indeed, is the spirit in which the 
eugenist must work. The man who declared he would 
do nothing for posterity — "for what has posterity done 
for me" — would never have been able for to shine in 
the high eugenic line. And there is a kind of eugenics 
characterized by the lopping off of all save one of the 
rosebuds on a branch so that the one may become mag- 
nificent by absorbing the sap the others should have 
had ; but that kind of eugenics had no place in Galton's 
scheme. He became enthusiastic to perpetuate his own 
Olympian status, nobly desirous that all humankind 
might become eugenized — well born, in the highest sense 
of the word — that there might come into being "races 
of highly gifted artists, saints, mathematicians, admin- 
istrators, mechanicians" and the like. 

Galton's mantle fell on Karl Piers on who both in 
lofty spirit and in good works has borne it exceeding 



EUGENICS 105 

well. Pearson states Galton's opinion to have been that 
progress toward increased race efficiency is feasible 
by two routes : the scientific study of heredity and en- 
vironment as they bear on race development; and a 
popular movement emphasizing the importance of these 
factors in national life and the urging of their right 
appreciation by legislators and social reformers. But 
to-day it would seem that, whilst travel by the former 
route is taking the safe and sober course characteristic 
of true science, travel by the latter is going by such 
breakneck speed as to invite sure disaster, and to be 
both disheartening and exasperating to those whose 
route is the scientific one. Indeed, the valid science of 
eugenics has as yet made but little headway ; and Pear- 
son has feared that before it has become matured and 
substantially progressive "the whole subject would be 
made ridiculous by the efforts of an uninstructed press 
to tickle the taste of a jaded public, with "eugenic" 
marriages, "eugenic" babies and "eugenic" plays, in- 
terviews with officials of eugenics societies — all of which 
has nothing whatever to do with the problem of race 
welfare. Eugenics, Pearson deplores, is rapidly devel- 
oping into a topic for the poseur, the Kongressbummler 
and the paragraphist. Even eugenic publications and 
eugenic congresses are issuing statements demonstrably 
incorrect with regard to such vitally important topics 
as insanity, the mental defect or the influence of heredtiy 
and environment. Pearson considers that years of pa- 
tient medicosocial observation, genetic experimentation 
and study of family histories are necessary before 
knowledge can be obtained on which to base conclusions 
as to any of those subjects. To-day one may state 
with dogmatism akin to that of the theologian the laws 



106 A DOCTOR'S VIEWPOINT 

of eugenics; but this cannot yet be done scientifically, 
that is, reasonably. 

Pearson and his London colleagues reprehend such 
a dogma proclaimed in the name of eugenics as: "At 
last it is possible to give definite advice to those about 
to marry or those who do not wish to transmit their 
undesirable traits ; weakness in any trait should marry 
strength in that trait, and strength may marry weak- 
ness;" and they "stand aghast" at the evil worked by 
the rapid popularization of eugenics, feeling certain 
that a movement thus "careless of its facts and vaunt- 
ing in its conclusions must collapse." 

Among the many zealous American workers in the 
"eugenic field" are those in the Carnegie Institution's 
Station for Experimental Evolution at Cold Spring 
Harbor, New York, of which Dr. Charles B. Daven- 
port is the Director. Considerable important literature 
has thus far been given out from this Institution; 
(some of which, it must be noted, is adversely criticized 
by the London School we have just considered). Its 
Eugenics Record Office aims to be the country's clear- 
ing house for an investigation of race, of heredity, of 
blood lines; and it issues to all desiring it personal 
advice as to the suitability of prospective marriages, 
and the probabilities of inheritance. Thus far the data 
collected by this Office have been mainly of abnormal 
types ; but this has been because such information has 
been easier to get. And here it should be noted that 
scientific eugenists do not have to make experiments; 
our race is making them all the time and great many 
more than science needs for her observations. Some 
one wrote asking "if they were to have a farm up there 
in the woods and experiment on all sorts of freaks"; 
no, it was answered, such experiments are, melancholy 



EUGENICS 107 

to relate, all too many of them constantly being made. 
Every child-bearing marriage is an experiment in eu- 
genics, and there are as many experimental results as 
there are children born. 

The collection of normal data has been difficult be- 
cause many people have imagined eugenists to be in- 
terested only in imbeciles, degenerates, epileptics and 
the like ; but Dr. Davenport aims to collect from whom- 
soever will send their names, information about normal 
individuals, the talented, the genius, the comparatively 
right-minded and the right-moraled ; and he hopes, in- 
deed, that the American citizen's idea of social duty 
will include the recording and depositing with the Rec- 
ord Office of full information about his genealogical tree. 
In brief, the work of this office is to learn how every 
characteristic behaves in heredity. 

This Office is but three years old, yet thus far such 
facts as the following (which with all due deference 
to Pearson and his confreres we beg to set down, have 
been deduced) : If two epileptics marry, their children 
will all be epileptics ; the same is true of all imbeciles. 
If an epileptic or insane marries a normal individual, 
one-half or one-fourth of the progeny will usually in- 
herit the parental abnormality ; the others will probably 
be normal. A recessive trait (one present in undevel- 
oped germ form and never becoming active in a given in- 
dividual) may remain recessive for generations, but 
will very likely become active when it meets a like trait 
— recessive or not. The marriage of cousins is not bad 
in itself, if both families are of sound stock; but such 
marriage will naturally bring out any common traits 
and intensify weaknesses, recessive or otherwise. 

Those of auburn tresses (if naturally so) are mark- 
edly antipathetic and seldom marry those having red 



108 A DOCTOR'S VIEWPOINT 

hair, A good environment strengthens good traits, but 
it will not guarantee the conquest of a bad inheritance. 
Love, in a mature and sensible human being (but who, 
however mature, has ever been sensible in such prem- 
ises?) may be in itself a eugenic choice; the fact of 
two wholesome beings -wishing to spend their lives to- 
gether is like to be founded on instinctive traits that 
will make for a good inheritance, to be enjoyed by a 
normal posterity; but love offers practically no more 
than an even chance. (Nevertheless your thorough-go- 
ing eugenist, wise and mellow-natured man that he is, 
would not do away with love; he would preach no 
doctrine of scientific mating as opposed to the marriage 
of personal choice; but he would combine with love, 
if such a thing is possible, common sense and fore- 
thought.) Marriage with an individual of bad blood 
will tend to drag down the inheritance of good blood; 
imbecility is often introduced into "bloodlines" that 
have hitherto been good. One's inheritance cannot be 
judged by a consideration of the parents, for normal 
parents may have abnormal, even criminal children ; the 
inheritance must be traced back for generations, and the 
records of cousins, uncles, aunts, brothers and sisters 
must be examined : one does not inherit from his parents, 
but from the family germ plasm. 

Thus, the bona fide eugenist would have love and the 
"eugenic principles" go auspiciously hand in hand in 
the marriage of the future, for happier homes and 
healthier children; and for the minimum of insanity, 
of hereditary degenerations, pauperism and crime. And 
succinctly, the object of the Eugenics Record Office at 
Cold Spring Harbor is to "serve eugenic interests in 
the capacity of a repository and clearing house; to 
build up an analytical index of the traits of American 



EUGENICS 109 

families, to train field workers, to gather data, to co- 
operate with other institutions and with persons con- 
cerned with eugenic study; to investigate the manner 
of the inheritance of specific human traits ; to promote 
and to aid in the organization of new centres for eu- 
genic research and education ; to advise concerning the 
eugenic fitness of proposed marriages, and to dissem- 
inate eugenic truth." 



MEDICAL RESEARCH AND EDUCATION 

It were good, as has been said, for every man to know 
something about law; it were even better for every man 
to know something about medical science. Indeed, next 
to philosophy, which is the gist of all the sciences, 
where is there one comprehending so many others, re- 
lated so intimately to human life, entering into so 
many of the infinitely complex phases of civilization; 
what is there in human experience, from conception to 
the grave, alien to medical science? 

The physician must know much of physics — the na- 
ture of heat, of slectricity, of light, the mathematics 
of refraction, in order to get many of his beneficent 
results. Chemistry is ever medicine's handmaid. From 
mechanics does medicine derive, among much else, the 
principle of factors of safety, by which the body is 
enabled to bear the unusual strains of life, and to endure 
notwithstanding, to the end of man's allotted span. 
Architecture has found in anatomy the principle of the 
hollow pillar. What builder would proceed without 
consulting the hygienist and the sanitarian, for the help 
they can give in the manifold aspects of home life. 
What public work would be designed in defiance of the 
of the dictum that the health of the people is the su- 
preme law. The biological sciences (how objurgated 
by some is that word science, which means absolutely 
nothing else in all the world than just "knowing") — 
these sciences are furnishing medicine most valuable 
and salutary data as to the vital phenomena of heredity, 
environment, function and will. 

110 



RESEARCH AND EDUCATION 111 

Do you imagine the physician and the painter have 
no bond? Examine, then, more carefully the next time 
you see them the Venus of Botticelli and the Blessed 
Damozel of Rosetti; and recall that the models from 
whom these men painted were consumptives. How shall 
you understand Nietschke or Verlaine aright without 
knowing something of psychiatry. If you have not 
discerned pathology in literature, how toxemia coursing 
through the blood affects genius, read then again any 
page of poor tuberculous Robert Louis, or Lawrence 
Stearne or Marie Bashkirtseff ; or hear again such eerie 
music as much of pathetic Chopin's, notably the First 
Polonaise. If you think melody has nothing to do with 
medicine, reflect upon the Dancing Manias of the Mid- 
dle Ages and the Tango of to-day. Learn, too, of the 
hundreds — literally — of transcendent geniuses in liter- 
ature and the arts, who have succumbed most untimely 
and most drearily, for them and for us, to The Cap- 
tain of the Men of Death. Whereby the world has 
lost inestimable treasures of the soul and of the in- 
tellect. 

Have the poet and the physician nothing in common? 
Read, then, from the book here under review: 

"It is in the putting forth of the hypothesis that the 
true man of science shows the creative power which 
makes him and the poets brothers. His must be a 
sensitive soul, ready to vibrate to nature's touches. 
Before the dull eye of the ordinary mind facts pass 
one after the other in long procession, but pass with- 
out effect, awakening nothing. In the eye of the man 
of genius, be he poet or man of science, the same facts 
light up an illumination, in the one of beauty, in the 
other of truth ; each possesses a responsive imagination. 
Such had Bernard, and the responses which in his youth 



112 A DOCTOR'S VIEWPOINT 

found expression in verses, in his maturer and trained 
mind took the form of scientific hypothesis." (Foster). 

And this by Dr. Eliot, of Harvard: 

"The imagination of Darwin, of Pasteur, for example, 
is as high and productive a form of imagination as that 
of Dante, or Goethe or even Shakespeare, if we regard 
the human uses which result from the exercise of imagin- 
ative powers ; and mean by human uses not merely meat 
and drink, clothes and shelter, but also the satisfaction 
of mental and spiritual needs." 

The physician must be a metaphysician also who 
would consider aright emotional epidemics, such as the 
Crusades, Witchcraft and the modern congeners of 
these phenomena. He will never have studied history 
aright who does not grasp (most historians have not) 
the part which pandemics of such diseases as Bubonic 
Plague, cholera, smallpox, malaria and the Great White 
Plague have played in human affairs. How oftentimes 
has medical jurisprudence served the ends of justice. 
Though the practice of theology and of medicine are 
to-day, fortunately, not often united in the individ- 
ual, they are nevertheless as essentially complemental 
as they were in the stone age, when the offices of priest 
and physician were one. And the President-Emeritus 
of Harvard has told us that no religion is worthy the 
name which will not take sympathetic account of pre- 
ventive medicine. 

Consider, too, how horrendous a part syphilis plays 
in social life; that tuberculosis has ever been and is 
now one of the most dreadful economic degradations in 
civilization. And the highest statesmanship is seeing in 
preventive medicine a pillar of fire lighting the way to 
national happiness and the worthiest prosperity of 
peoples. 



RESEARCH AND EDUCATION 113 



II 



The universality of medical science is superbly dem- 
onstrated in the book Medical Research and Education, 
to which many among the most illustrious medical minds 
in America have contributed.* The spirit and purpose 
of this book are well indicated by Professor Richard M. 
Pearce : 

"Wonderful as were the isolated achievements of the 
great discoveries in medicine in the early centuries, the 
great continuous advance in medicine during the past 
eighty years resulted from organized laboratory effort 
based on the principle of exact experimental methods; 
and it is the duty of the university so to organize its 
laboratories and hospital that this advance of medicine 
by research may continue, side by side with teaching, 
as a university function of benefit to students and fac- 
ulty, as well as to the state and the general public wel- 
fare, and thus as an aid to the advancement of civiliza- 
tion." 

In this book one shall come upon English as masterly 
and as ingratiating as any to be found in literature; 



^Medical Research and Education, by Richard M. Pearce, The 
University of Pennsylvania; William H. Welch, W. H. Howell, 
Franklin P. Mall, Lewellys P. Barker, The Johns Hopkins Uni- 
versity ; Charles S. Minot, W. B. Cannon, W. T. Councilman, 
Theobold Smith, Harvard University; G. N. Stewart, Western Re- 
serve University; C. M. Jackson, E. P. Lyon, University of Minne- 
sota; James B. Herrick, Rush Medical College; John M. Dodson, 
University of Chicago ; C. R. Bardeen, University of Wisconsin ; 
W. Ophuls, Stanford University; Samuel J. Meltzer, Rockefeller 
Institute for Medical Research ; James Ewing, Cornell University 
Medical College; W. W. Keen, Jefferson Medical College; Henry 
H. Donaldson, Wistar Institute of Anatomy; the late Christian A. 
Herter, Columbia University; the late Henry P. Bowditch, Harvard 
University. The Science Press, New York and Garrison, New 
York, 1913. 



114 A DOCTOR'S VIEWPOINT 

upon observations as pregnant as any to be found in 
philosophy. To quote : 

"The human being is a part of the whole of nature 
and cannot be understood without it. What is wanted 
is a satisfactory general view of the process of the 
universe. Possessing this, we shall find the key in our 
hands which will open the most secret recesses of the 
art of medicine." — Gomperz. 

"It is well that the sciences of nature hold out at- 
tractions to so many different types of mind, for the 
edifice of science is built of material which must be 
drawn from many sources. A quarry opened in the 
interest of one enriches all of these sciences. The 
deeper we can lay the foundations and penetrate into 
the nature of things, the closer are the workers drawn 
together, the clearer becomes their community of pur- 
pose, and the more significant to the welfare of mankind 
the upbuilding of natural knowledge." — Welch. 

"Some day, perhaps, the mystery of life and being, 
which presses on the physiologist as on other men, and 
indeed, with a double weight, may be solved. Some day, 
perhaps, man may know not only what he is, but why 
he is. To-day, after but three thousand years of his- 
tory and three hundred of science, it were indeed diffi- 
cult to imagine how this can be so. We can only trust 
that it may be. Some far-off to-morrow may arrive, 
when the clearer vision of a million of years of science 
and of history may fathom the secret and read the 
reconcilement of the hopes and the destinies of man. 

"A hair, they say, divides the false and true ; 

Yes ; and a single Alif were the clue ; 
Could you but find it, to the Treasure-house 

And peradventure to the Master, too." 

— Stewart. 



RESEARCH AND EDUCATION 115 

"In the field of observation chance favors the pre- 
pared mind." — Pearce, quoting Pasteur. 

"Remarkable achievements are never unique occur- 
rences in nature. Even the greatest men rest on the 
shoulders of a large multitude of smaller ones who have 
preceded them ; and epochal discoveries emerge out of a 
period of intellectual restlessness that affects many 
minds." — Flexner. 

"Every citizen should be inspired with love of per- 
sonal and public hygiene, as were the Greeks. Every 
physician should be deeply grounded in physiologic 
medicine and provided with proper facilities for using 
it practically. Every public health officer should know 
thoroughly the contributions of etiologic medicine. All 
efforts should be made to promote these fundamental 
needs of society." — Bardeen. 

"The discoveries which have transformed the face of 
modern medicine have been in the field of infectious 
diseases, and in no other department of medicine could 
new knowledge have meant so much to mankind, for 
the infectious diseases have a significance to the race 
possessed by no other class of disease, and problems 
relating to their restraint are scarcely less social and 
economic than medical. — Welch. 

"We cannot agree exactly on what a 'good doctor' 
is. Some will say 'Practical'; some will say 'Scientific'; 
some will say 'Knowledge'; some will say 'Heart.'" — 
Lyon. (The good doctor should be all of these). 

"Wonderful as were the isolated achievements of the 
great discoverers in medicine in the early centuries, 
the great continuous advance in medicine during the 
past eighty years resulted from organized laboratory 
effort based on the principle of exact experimental meth- 
ods ; and it is the duty of the university so to organize 



116 A DOCTOR'S VIEWPOINT 

its laboratories and hospitals that this advance of med- 
icine by research may continue, side by side with teach- 
ing, as a university function of benefit to students and 
faculty as well as to the state and the general public 
welfare, and thus be an aid to the advancement of 
civilization." — Pearce. 

"It is the privilege and duty of hospitals to extend 
their field of usefulness by opening their wards more 
freely to undergraduates in medicine, to elevate the 
standards of work done by nurses, internes, residents 
and attending staff, to foster research. By so doing 
they are not harming the patients, but are rather in- 
suring them better and more skillful treatment. They 
are serving to enlighten and educate not only the indi- 
vidual, but the observing public as well, eager to learn 
and to be instructed in knowledge of medical matters." 
— Herriclc. 

"He who purposes to study medicine should have in 
high degree three gifts, not one of which is common 
among mankind, yet all of which he must have: the 
power of reliable observation, intellectual endurance; 
loyalty." — Minot. 

"The die is cast, the book is written, to be read either 
now or by posterity, I care not which. It may well 
wait a century for a reader, as God has waited six 
thousand years for an observer." — Kepler. 

"We may regret the loss of many charming features 
which have been erased from the landscape of science 
by all of this minute specialization, of which no one 
can foresee the end, and such a sentiment is much the 
same and as unavailing as that for the return of the 
days of the stagecoach. The great instruments of 
progress in modern life — steam and electricity in the 
industries, subdivision of labor and increasing special- 



RESEARCH AND EDUCATION 117 

ization in science — are not altogether lovely, but they 
are the conditions of advancement in material pros- 
perity and natural knowledge." — Welch. 

"There is one quality the possession of which is the 
supreme need of the physician, without which he is as 
unfit and useless as a tone-deaf musician or a color blind 
painter; that is, the faculty of exact observation." — 
Minot. 

"Accurate observation is by far the most difficult 
art which mankind has ever essayed. A nation may 
count on furnishing abundance of military talent, 
plenty of politicians and statesmen, enough of com- 
petent lawyers ; it may even hope to have gifted artists 
and authors; but it can scarcely expect to produce a 
single master of the art of observation in a century. 
In a century Germany produces one Helmholtz, France 
one Pasteur, England one Darwin — an American peer 
of these three is yet to become known." — Minot. 

"The most familiar sign of the public misconception 
is displayed in the effort of the daily press to furnish 
information on medical topics. With rare exceptions 
these efforts consist of sensationalism, personalities, 
wonder-tales, absurdities, and a general display of the 
haste and incompetence of the writer. Every medical 
article written for the public press should first be sub- 
mitted to a competent medical expert for revision. More 
pernicious still is the influence of a score of semi-medi- 
cal journals which cater to the taste for misinforma- 
tion and absorb a large portion of the $50,000,000 paid! 
annually in this country in the advertisement of quack 
medicines." — Ewing. 

"I like to think of medicine in our clay as an ever- 
broadening and deepening river, fed by the limpid 
streams of pure science. The river at its borders has 



118 A DOCTOR'S VIEWPOINT 

its eddies and currents, expressive of certain doubts 
and errors that fringe all progress; but it makes 
continuous advances on its way to the ocean of its 
destiny. Very gradual has been the progress of its 
widening and deepening, for it is a product of human 
ingenuity and artifice, and only skilled engineers could 
direct the isolated currents of science into the some- 
what sluggish stream of medical utility ." — Herter. 

m 

Professor Pearce tells of six important activities 
in scientific medicine in the present day: 

1. Immunity is the very basis of preventive medi- 
cine; it is one of the most fundamental properties of 
living things; by it untoward environmental agencies 
are repelled. Immunology (or serology) would explain 
and apply the mechanisms by which one's body is en- 
abled to resist disease; and this science seeks to es- 
tablish laws for the conditions determining natural 
resistence to infectious disease, and for the factors 
which increase or diminish this resistance. 

Up to 1890 bacteriologists were studying almost en- 
tirely the causation of the germ — that is, the bacterial, 
the infectious diseases, and were attempting, with con- 
siderable success, to combat these diseases by means 
of vaccinations (still a most valuable proceeding). 
Since then, however, a new and ever-widening field 
of investigation has been opened, in which have been, 
and are being studied: the mode of action of invading 
germs and the mode of action of their products (tox- 
ins) ; the processes of infection and of intoxication ; the 
mechanism by which the host combats the invasion and 
aborts or throws off such infection. Also it was found 



RESEARCH AND EDUCATION 119 

that the toxins (poisons) generated by the bacteria 
produce not only an often fatal intoxication (toxemia) ; 
but that each toxin thus developed has its distinctive 
effect. The poison of each bacterium has its own 
peculiar and specific action. (For example, one does 
not contract any other disease than typhoid from 
the typhoid germ). Thus was begun the serum ther- 
apy through which were evolved the wonderfully ben- 
eficent diphtheria and tetanus antitoxins, and the im- 
petus thus given has lead to investigations of great 
and permanent value. 

Among the bodily forces above indicated we can 
here mention only: phagocytosis, by which our white 
blood cells engage in a Homeric, though microcosmic 
battle with the invading bacteria, either engulfing, lit- 
erally "eating 'em alive" (when the host recovers) ; 
or being themselves destroyed by the invaders (the 
host dying in consequence) ; the bacteriolytic (germ- 
destroying) properties in certain body fluids ; the prop- 
erty in blood serum of agglutinating or clumping to- 
gether pathogenic germs ; the opsonins, those substances 
in blood serum (opsono, I cater to) which have the 
power to prepare bacteria for ingestion and digestion 
by the white blood cells. We must mention also the 
extension of Pasteur's principle of vaccination to pro= 
tective (prophylactic) vaccinations against cholera, 
plague and typhoid fever; and the contribution in 
recent years to the list of curative sera of the antimen- 
ingococcus serum, used against cerebrospinal meningi- 
tis, a disease which heretofore has had a mortality of 
practically one hundred per cent. And as to the 
dreadful disease cancer, against which thus far the only 
hope is the knife, "no one of those most conversant with 



120 A DOCTOR'S VIEWPOINT 

the problem would be surprised to find to-morrow that 
it has been solved and that cancer is curable, 5 ' 

2. The bacteria are vegetable parasites; the pro- 
tozoa are animal germs or parasites. Among the lat- 
ter the essential causes of amoebic dysentery and ma- 
laria were discovered before 1890; since then fifteen 
diseases are known or suspected to be of protozoal 
origin. And protozoology has resulted in the discovery 
of the role mosquitoes play in the transmission of dis- 
ease-germs; in the formerly pestilent Tropics being 
made habitable for the white man; in the achievement 
of Gorgas, without which the Panama Canal would 
never have been built. 

3. "Our little Ehrlich" (that dukkopf who could or 
would not pass his exams and who was nearly flunked 
in consequence, but who instead busied himself with 
a most extraordinary variety of chemical compounds), 
has created a new science, chemotherapy, based on the 
principle that a specific chemical affinity exists between 
living cells and given chemical substances. Ehrlich 
believed that for each specific parasite a specific cura- 
tive drug could and must be found. The destruction 
of germs, animal or vegetable, outside the body is a 
commonplace of surgical and public health measures ; 
but the destruction of such germs within the living 
body has never, until Ehrlich accomplished it, been 
possible — not without at the same time destroying also, 
in part or in toto, the cells of the host. To avoid the 
latter it was necessary, therefore, that the protozoa- 
destroying substance should have a specific chemical 
affinity for the protozoa in question, but little or none 
for the cells of the host. Ehrlich's most brilliant suc- 
cesses thus far have been with Salvarsan, the 606th 
chemical combination with which he experimented in 



RESEARCH AND EDUCATION 121 

the treatment of syphilis ; and his arsenic compound 
(arsenophenylglysin) a single dose of which absolutely 
and permanently cures all animals suffering from 
trypanosomiasis (the sleeping sickness). There are 
now about a dozen drugs which can be used to cure or 
modify diseases caused by as many different protozoa. 
Wherefore chemotherapy promises results which (with 
serotherapy and vaccination for bacterial diseases) 
"will sharply limit the ravages of the transmissible dis- 
eases of man and animals." 

4. The early physiological chemistry was largely 
the analysis of the chemical composition of various 
body tissues and fluids. This idea, however, soon gave 
way to a dynamic idea, that of function; and present- 
day investigators in this science are concerned chiefly 
with the ways and means of cell action. (All life, by 
the way, is essentially cellular ; and all cells, from con- 
ception on, are derived from cells. Omnis cellula e 
cellule). The fundamental problems now engaging the 
workers in this field are (1) the chemical composition 
of the protein molecules; (2) the part played by fer- 
ments in the changes occurring within the living cell 
and which are responsible for the functions of the va- 
rious organs and tissues; (3) the general problem of 
nutrition and the relative values of different foodstuffs ; 
(4) the question of the interrelation of function — 
that is, of the influence of the secretion of the cells of 
an organ or tissue on the cells of a remote organ or 
tissue; (5) the mechanism, from a chemical point of 
view, of natural or acquired resistance to disease and 
of phenomena associated with such resistance. 

5. Experimental pharmacology or Pharmaco-dy- 
namics applies the methods of physiology and chem- 
istry to the study of the action of drugs, poisons and 



122 A DOCTOR'S VIEWPOINT 

other substances which may alter normal function. 
This science includes not only the study of the mode 
of action of remedial agents in healthy individuals and 
the influence of such action on various abnormal con- 
ditions, but also, the effect of a great variety of sub- 
stances, in short, of all animal, vegetable or mineral 
substances in any way capable of altering normal 
physiology. Nor is the study of the effect of these 
substances limited to man and the higher animals ; but 
it includes the use of the lower invertebrate forms, 
bacteria and protozoa. It is, therefore, an all-inclu- 
sive branch of biology, dealing with the comparative 
study of the action of chemical bodies on animal life. 
Its achievements are of interest to physiology, to which 
science it has contributed much, both in method and 
in fact: to chemistry, in that pharmacology has added 
largely to the data concerning the interaction of cell 
and chemical substance; and to practical therapeutics, 
in that it presents new remedies, explains the action 
of old ones, and defines the limitations of drug therapy. 
And it has a definite relation to the general public 
welfare in that, by its methods, it establishes procedures 
for determining the potency of therapeutic remedies; 
thus preventing, on the one hand, ill effects from a 
drug of unusual power ; and, on the other, guaranteeing 
a remedial agent of standard strength. 

6. Experimental Pathology and Pathological Phy- 
siology are branches of pathology and physiology 
which, combining the methods of both those sciences 
with those of chemistry attempt, by the study of ab- 
normal conditions experimentally produced, to explain 
the disturbance in function consequent upon cell or 
tissue injury or disturbances in physiological or chem- 
ical equilibrium. Co-ordinating as they do the methods 



RESEARCH AND EDUCATION 128 

of several of the medical sciences and having for their 
object the elucidation of definite problems in clinical 
medicine, they are essentially the methods of a science 
of clinical medicine, and have added materially to the 
latter's advance. 



EDITORIAL EFFUSIONS 



HOW GENIUS MANIFESTS ITSELF 

A great sculptor once had his soul so saturated with 
a wonderful sunset — its softness, its calm, its quiescent 
and gradual change of coloring and its peace-suffusing 
quality — that he wanted to portray it; but he was no 
painter. So instead he wrought in marble a little child 
asleep; and this he did so successfully that people 
contemplating the equanimity and trustfulness in its in- 
fant countenance, the stone that seemed almost to be re- 
spiring, declared that it put them in mind of a sunset 
and were bettered accordingly. So also fifty years ago a 
boat builder (this is imagined for the facts are not 
known nor do they in the least matter, since they "have 
nothing at all to do with the case") was profoundly 
moved by a queenly, a soul compelling, and a good 
diffusing woman; but he was no poet and could not 
manifest his devotion in rhyme and rhythm. Yet his 
imperative ambition was to interpret his inspiration 
into something that might in turn benefit the world. 
So he built a poem: he designed a most beautiful white 
vessel with exquisitely graceful lines ; and he named 
her the Mary Powell. And so trans cendently delight- 
ful was that vessel, when outlined against the loveliest 
scenery in the world, so swift and sure her course 
along the noblest river, dashing the rainbowed spray 
from her bow, so benignant her existence, that these 
fifty years past people have never tired admiring her, 

124 



EDITORIAL EFFUSIONS 125 

"many an eye has danced to see" her flag in the breeze ; 
many a heart has throbbed at her passing, and from 
first to last men have called her, perfectly compre- 
hending her designer's inspiration, The Queen of the 
Hudson. So from the beginning of the race have su- 
perb women moved men to glorious works; and never 
has such admiration been more justified than when 
translated into utilitarian achievements. The Mary 
Powell is going to the scrap heap! That is what it 
really amounts to, though her owners are trying to 
break it gently to the many thousands who love her 
and cherish memories of those with whom they spent 
hours on their runs. "She will make occasion trips." 
This, any discerning person can see, is but softening 
the blow. Soon she will pass away along with such 
gray heads as began their wedding trips on the sym- 
pathetic decks. But that is the appointed course for 
beautiful women and devoted men, and wonder- fashioned 
vessels, as well as for all and everything else in the 
cosmos. 

THE HUMANNESS OF SCIENTISTS 

There is among many a misconception of the man 
of science as a morally and emotionally shriveled speci- 
men who remorselessly sacrifices romance and poetry 
and human ties in crassly materialistic pursuits. The 
comparison of this misconception with the behavior of 
many typical scientists is distinctly ludicrous. Take, 
for example, the famous X Club. 

This was essentially a dinner club ; the members who 
attended its first meeting were Hirst, Spottiswoode, 



♦This matter has appeared in various journals. The editorial 
"we" is retained, rather than a change being made to the Teddy- 
veltlan first person. 



126 A DOCTOR'S VIEWPOINT 

Tyndall, Frankland, Huxley, Hooker, Busk, Avebury, 
and Spencer. Later members were Darwin and many 
another of those amazing nineteenth century giants. 
"It has happened," observed Huxley, "that these cronies 
have developed into bigwigs of various kinds, and there- 
fore the club has incidentally — I may say accidentally — 
a good deal of influence in the scientific world." Hux- 
ley once overheard two members of the Athenaeum: 
"I say, do you know anything about the X Club?" 
"Oh, I have heard of it." "What do they do ?" "Well, 
they govern scientific affairs ; and really, on the whole, 
they don't do it badly." 

Nevertheless, a guest of this club must have been 
shocked and saddened by the frivolity obtaining among 
its members. There were no rules, save the unwritten 
law not to have any. But skeletal minutes were kept, 
as "Talked politics, scandal, and the three classes of 
witnesses; liars — damned liars, and experts." Excur- 
sions were organized for the members and their wives, 
as recorded by the algebraic notation "x's plus y'vs;" 
the "x's" of the outings to be paid by the "x's." It was 
suggested in the beginning to name this club the 
"Blastodermic," that being the part of the ovum in 
which the rudiments of future organism first appear; 
apparently "x" was decided on because it stood for the 
unknown quantity, and so committed the club and its 
members to nothing. In this coterie the observation of 
Herbert Spencer seems to have been lived up to : "It is 
a great mistake for adults, and especially those who 
work their brains much, to give up sports and games. 
The maxim on which I have acted is, be a boy as long 
as you can." 

Among the reminiscences of Uncle Dan, a Harvard 



EDITORIAL EFFUSIONS 137 

man of the era when Hallis and Haleworthy were up- 
to-date dormitories are these: 

One morning James Russell stood, hat in hand, to 
assist absent-minded Dr. Peabody (whose sight was 
not so good as it used to be) to alight from the old 
horse-car in Harvard Square; the ever-humane doctor, 
seeing the inverted hat, dropped therein a coin, with 
a "There, my good man, there!" Lowell ever after 
cherished the coin as a memento. 

The Autocrat of the Breakfast Table was once a 
guest — and a very approachable one — at the Profile 
House, in the White Mountains. One evening char- 
ades were in order; and Holmes asked permission to 
put one on. This was joyfully agreed to; whereupon 
he had a brief consultation with a friend. The latter 
then appeared, as if for a morning stroll, and rambled 
aimlessly upon the stage; then Holmes followed, walk- 
ing briskly; the two gentlemen met, saluted cordially, 
and then left the stage. "A word of five syllables in 
that one act," announced Holmes. Nobody could guess 
the word, which was "met-a-physician." 

The appreciation of this charade was so cordial that 
Holmes was asked to give another. He and his fellow- 
conspirator complied ; to everybody's mystification they 
went through precisely the same scene. "A word of 
three syllables in that one act," announced Holmes this 
time ; the word was "metaphor." Uncle Dan tells how, 
when Holmes was just a struggling young doctor some- 
where along Charles Street, he once threatened to put 
out a sign, "Small fevers gratefully received." 

We may add here the experience of James Payn, 
at one time editor of the Comhill Magazine, the door 
of whose sanctum was one day opened by an unan- 



128 A DOCTOR'S VIEWPOINT 

nounced caller. The latter had a goodly roll of papers 
under his arm, whereby Payn scented a poet with a 
never-ending epic. "Well, sir?" "I've brought you 
something about sarcoma and carcinoma," announced 
the caller. "We are overcrowded with poetry — 
couldn't accept another line, not even if it were by 
Milton." "Poetry !" flashed the caller indignantly ; "do 
you know anything about sarcoma and carcinoma?" 
"Italian lovers, weren't they?" ventured Payn. The call- 
er retreated in the greatest wrath ; under the same roof 
as the Cornhill was the office of a medical and surgical 
journal, and that it was had been sought by the medical 
writer of the treatise on those lesions with the eu- 
phonious names. 

PULICIDE 

Some may imagine it to be an easy thing to kill a 
flea; such delusion will be dispelled by the following 
statements, which are authoritative, being based on a 
report on Flea Destruction of the United States Public 
Health and Marine Hospital Service. It should be 
premised, however, that the investigation noted, though 
thoroughly scientific, was limited in scope ; for only the 
Pulex irritans, the Hoplopsyllus anomalus and the 
Ceratophyllus acutus, with two other varieties were ex- 
amined; and, as every one knows, this is but touching 
the fringe of the flea question. 

Pretty much every insect can be destroyed by corrod- 
ing it with chemicals, or by suffocating it outright, or 
by euthenizing it with ether or chloroform or laughing 
gas. Not so, however, the festive flea, which will 
survive all these modes of execution combined, with 
others added. It will survive the agency which kills 
its "host," such as the rat or the squirrel; and (with 



EDITORIAL EFFUSIONS 129 

its marvelous power of jumping across infinite dis- 
tances) will find a new boarding place in another hos- 
pitable and as yet unvivified pelt. Besides, when can 
one say that pulicide is a deed accomplished? A 
flea that has not moved for half an hour has been 
pronounced dead ; yet the abandoned creature has after- 
ward sprung up as ready as ever for the part allotted 
it in the cosmic scheme by a hopelessly inscrutable 
Providence. Again, what were the conditions of the 
flea before the attempted vivisection? Was it mori- 
bund, or was it physically up to par? It has been 
calculated that, size for size and weight for weight, if a 
man's jump had as much power behind it as a healthy, 
robust flea's, he (the man) could easily, from the 
street, clear the golden ball topping he flagstaff of 
the Woolworth building. So, for the conditions of the 
experiment, it should be known beforehand if the crea- 
ture has its jump in normal working order. Again, cli- 
matic conditions must be considered; the flea will hop 
and bite with energy in dry, crisp weather ; on a soggy 
dav he may not care to do these things, and so may 
only seem to be dead. 

It is almost impossible to drown fleas by dropping 
them into water ; but soap and water will do for any flea. 
Thus is the flea the hobo among insects ; for dipped in 
tincture of green soap he is dead beyond peradventure 
in two minutes, and no flea of the five kinds indicated 
could live after being soaped. Another evidence (among 
so many) of the disreputable character of the flea is 
that when soaked in absolute alcohol, he may become 
paralyzed; but he will certainly recover, and (as in 
the old song) when one puts his finger on him, behold 
he is not there. The strongest whiskies are only fifty 
per cent, alcohol; and there is surely no record of any 



130 A DOCTOR'S VIEWPOINT 

human survivor who has been submerged in whisky ; yet 
fleas come out seemingly all the better for it, after 
being soaked in absolute alcohol (98 per cent.). Again, 
a flea left to swim in formalin (a very powerful insec- 
ticide) was "apparently dead in twelve hours," but 
"revived." It took 100 per cent, phenol more than one 
minute to kill a flea, etc. The conclusion is that water 
is of little value in flea destruction; glycerine is prac- 
tically inert ; alcohol is practically inefficient ; kerosene 
and miscible oil are efficient ; formalin, phenol, mercuric 
chloride and trekesol in the strength used as disinfect- 
ants are of little value, and powdered sulphur of none ; 
the fumigants, bisulphide of carbon, hydrocyanic acid 
gas, and sulphur dioxide are "highly efficient in the 
strength employed for flea destruction." 

It would seem, on the whole, that the surest way to 
kill a flea (and be able to testify under oath that he is 
really defunct) would be to place him on one of those 
impenetrable plates used in naval warfare, and con- 
fine him thereon by means of cables fastened securely 
to each of his several legs; then to train upon him 
(from as near a distance as would be feasible) an 
irresistible projectile from one of those twelve-inch 
guns. If the flea should not (by reason of the phe- 
nomenal spring mentioned) break away and get out 
of range, it might fairly be assumed that its destruc- 
tion beyond resurrection had been consummated; that 
is, considering the unerring aim for which the Ameri- 
can navy is so justly famous: if the experiment were 
tried in the Cuban or the Patagonian navy, one would 
be rash to guarantee the result. 



EDITORIAL EFFUSIONS 131 

UNSCIENTIFIC FUTILITIES 

True science is perforce both sane and utilitarian; 
and her votaries have ever definite objects in view, 
which they seek by reasonable and practical means. 
There have been instances of doings assumed to be 
scientific that would hardly fill these specifications, but 
which have a jocund interest and may besides possibly 
have instructive point. 

An illustrious nature lover (and not a nature fakir 
by any means) becoming interested in the question 
"Why does a mosquito refuse to touch a frog?" and 
perhaps with an ultimate view to the elimination of 
both these pests, rightly concluded no fair answer 
could be given the question until it was determined 
if the mosquito does really make this blessed exception. 
So the experimenter repaired after nightfall to a marsh, 
where he held up a frog in the presence of the mosquito 
host. His hand was most grievously bitten, while the 
frog had never the slightest occasion to scratch him- 
self. One is here reminded of the Hibernian gentleman 
who held his dog all night in the snow to freeze it. It 
appears never to have occurred to our nature lover 
to have saved himself those dreadful stings by wearing 
a glove stout enough to be impermeable even to mosqui- 
toes. Nor for all his pains did he prove anything worth 
while. For whether mosquitoes sting frogs or no, the 
two genera have from time immemorial been known to 
flourish in the same sort of place. There seems to be 
an amicable relationship, a sort of business understand- 
ing between them, the mutual object being the vexation 
of humankind. True, frogs are supposed to eat mosqui- 
toes; but this seems to be done genially and without 
heat, after the fashion of the companionable walrus 



132 A DOCTOR'S VIEWPOINT 

in "Alice in Wonderland," who after dancing with the 
oysters, tearfully devoured them. And yet the alleged 
proclivity on the part of frogs, to eat mosquitoes, seems 
not to have diminished the visible and working supply 
of the latter. Their j oint presence in marshes has been 
so detrimental to nocturnal comfort and to the value 
of nearby real estate that something ought certainly 
be done — something rational, however. These creatures 
are both musically inclined and presumably they enjoy 
each other's songs — a penchant not generally shared 
by their human neighbors ; and yet after some persons 
we have heard sing, we should rather, if we had to 
make a choice, decide not unfavorably to the marsh 
denizens. Be all this as it may, the only rational pur- 
pose of any experimentation in the premises would be 
the elimination of the mosquito and the frog; and 
there is no other way to achieve this than to drain 
the marshes. 

Another "scientific gent," a resident of the cactus 
belt, was some time ago (possibly still is) zealous for 
the formation of a cult of cactus eaters. The spineless 
cactus of lower California has been his favorite food; 
he has been eating it, drinking concoctions of it, taking 
it in soup and omelette and salad; and he gained 
weight in the fortnight when he lived exclusively on 
cactus. Nevertheless he has, no doubt, long before this, 
found the habit an absurdly expensive one; and any 
cactus-eating cult, unless it be made up of millionaires, 
must inevitably die out for the monetary reason alone. 

It was some time ago reported that a fellow-citizen 
has made a will consigning his body, after his death, 
to various mechanical uses. Buttons are to be made 
of his bones ; leather bags of his skin ; fiddlestrings of 
some of his more intimate internal relations. This 



EDITORIAL EFFUSIONS 133 

gentleman proclaimed himself a utilitarian, determined 
to practice his creed to the very death. Yet his phil- 
osophy is really not utilitarian. For the bone button 
market is now so well supplied, these articles some- 
times get into places where they certainly have no 
business — into soup, for a horrible example. And there 
is no dearth of fiddlestrings — more's the pity. And 
what normal individual would care to buy and have 
about him bags made of human skin — and this in 
an era when felines and canines, whose pelts would* 
make much better bags, are so prolific and can be had 
so reasonably as to expense. In point of fact, it would 
cost more to transfer the mortal remains of this pseudo- 
utilitarian into merchandise than the product would 
bring in the open market. 

CUPID IN PSYCHOLOGY 

Prof. G. Stanley Hall has devised a new and a sci- 
entific definition of love. Of course, there have been no 
end of definitions of this cosmos-pervading emotion, 
hundreds of which are recorded in any one of those 
gilt-edged volumes with flowers on the cover and a 
silk painted or embroidered book mark worked into the 
binding — a volume for which any right-minded man 
under thirty would gladly pay three dollars and feel 
he had made the best investment of his life (except 
of course the one he might find in that path lighted up 
by that book). But the definition we are about to 
submit to the eager reader is "different." We might 
observe that it has a Hall-mark peculiarly its own, and 
that it is not likely to find its way into future treatises 
on poesy. It is a six-ply definition, as follows: Love 
is "emotive delusion, fixed idea, rudimentary paranoia, 
psychic neurasthenia, episodic symptoms of hereditary, 



134 A DOCTOR'S VIEWPOINT 

degeneracy, and psychic emotive obsession. We shall 
leave it to the reader to make out what Dr. Hall has 
been driving at, selecting for comment only the phrase 
"rudimentary paranoia." Here seems to us an en- 
trancing phrase, which might be very agreeable to 
femininity when rendered 'neath the summer moon, 
softly and mellifluously, as in a song to one's own ac- 
companiment — that is, if one is quite positive he knows 
how to sing. And yet some might hold that "rudi- 
mentary paranoia" sounds blood thirsty. Well, we 
confess this the more inclines us toward it; we are 
taken with its primitive, elemental verve. And we might 
just as well express here our impatience with present- 
day methods of love-making. It irks us to think of 
young men constantly on their knees (he who begins 
there will always stay there), fooling away the time 
that should be used in doing the World's Work, whilst 
the maiden backs and fills, as: "I will and I won't; 
maybe and yet I am not sure; this is so sudden; I 
will be a sister to you until we know each other 
better; and, father will miss me so; and, how can I 
live without mother;" and so on. Much preferable the 
good old primeval plan when one, having developed a 
healthy, robust rudimentary paranoia, selected a fairly 
sizeable club, sought out the object of his adoration, 
fetched her a whack on the head (nothing brutal, of 
course, but just sufficient to the end in view), and 
carried off to his abode her unresisting form. Depend 
upon it, homes were happy in those days ; with no talk 
of divorces or suffragism or feminism or such like 
f older ols. 

SOCIAL EXCITEMENTS 

Something like a decade ago a Washington news- 



EDITORIAL EFFUSIONS 135 

paper correspondent wrote of a Congress of the Daugh- 
ters of the American Revolution and its disorderly meet- 
ings : "It is the unanimous opinion of those who have 
attended the Congress that, while the Daughters of 
the American Revolution, individually, are nearly all 
intelligent, refined and attractive women, collectively 
they are an uncontrollable mob." These identical words 
would have been re-applicable to the Twentieth Con- 
tinental Congress, held in April last, of these same 
Daughters of the American Revolution. Again all sorts 
of heinous accusations were made; not once, but fre- 
quently, was "a rumpus started"; the Madame Pres- 
ident was, with approbrious intent, stigmatized by a 
member of the opposing faction as a "czar," an ab- 
solute and relentless despot being no doubt implied in 
this term. This same Madame President was alleged 
to have committed the heinous crime of changing her 
mind — a phenomenon which has from the very begin- 
ning of the race been agreed to be not at all a crim- 
inal proceeding, but rather a most indubitable right and 
privilege of the feminine nature. All sorts of disagree- 
able asseverations and unpleasant insinuations were 
made. The Revolution was thus, for at least the twen- 
tieth time, fought all over again; only the British had 
no hand in the business. The fighting was all done 
in the American camp, where all the casualties oc- 
curred. 

Now, every reader will surely agree, and that with- 
out qualification, with the Washington correspondent 
we have quoted, as to the charm, the amiability, the 
sense of justice and the gentlewomanliness of each and 
every one among those Revolutionary Daughters. By 
what occult processes, then, is the normal individual, 
on becoming a member of an assemblage, likely to 



136 A DOCTOR'S VIEWPOINT 

take leave of his or her natural temperament and 
characteristics ; by what means is the human unit, im- 
mediately it becomes merged in a crowd (meaning by 
the term a collection of people) moved to do and say 
things that would not be thought of in the individaul 
capacity. These psychic factors are mainly sugges- 
tion and the force of inordinate social excitement; 
under their influence the individual loses the power of 
calm observation, of logical thought ; for the time being 
he is no longer "king of all that is under his own hat ;" 
his highest and last developed cerebral functions (rea- 
son and judgment) are for the time being inhibited, 
and "out of the circuit." (These phenomena apply 
equally to males ; so let us now write our observations 
as of the masculine term, since "man embraces woman.") 

The individual in the crowd, then, has for the time 
being, undergone reversion ; he assimilates with unusual 
readiness the ideas of others, however unreasonable 
they may be; and he proceeds in accord with those 
with whom he has associated himself, however unrea- 
sonable or unfair their proceedings may be. 

Suggestion is "the insinuation of a belief or impulse 
into the mind of the subject by any means, as by words 
or gestures, usually by emphatic declaration." The 
art in suggestion lies in the ability to present an idea 
in such a persuasive, convincing and apparently prob- 
able light as to command the assent of the subject. The 
process is precisely represented in the everyday ex- 
pression: "What made you put that idea in his head." 
The essential difference between suggestion and hyp- 
notism is that in the latter the subject arranges be- 
forehand to submit to hypnotism. He is generally 
fully aware that he is about to undergo the process. 
Suggestions are oftener than not implanted in the sub- 



EDITORIAL EFFUSIONS 137 

ject's mind when he is unaware of the transference; 
the act of reception may be — generally is — involuntary ; 
in suggestion the subconscious mind may receive an 
idea to which the conscious mentality may be oblivious. 

As simple an instance as may be of the influence of 
suggestion is found in the act of yawning. Anyone 
can test this by yawning m a street car; the people 
in the seats opposite who see the yawn will presently 
yawn themselves. 

Anyone who wants fully to comprehend the force of 
inordinate social excitements should read the work of 
Gustave Le Bon, entitled The Crowd; a Study of the 
Popular Mind. To this profound thinker a crowd (be 
it a jury, a society, a legislative assembly or a congress 
of ladies such as we have instanced to begin with) is an 
entity not at all analgous in its psychism to that of the 
individual units which compose it. A crowd (in the 
sense here employed) cannot be depended upon to reach 
conclusions by the same processes that the self-poised, 
judicious, single reasoner employs. With the crowd 
the emotions hold full sway; and reason and intellect 
are set aside. "The mental quality of the individual 
in the crowd is without importance; from the moment 
they are in the crowd the ignorant and the learned (and 
let us add also the gracious and the kindly) are equally 
incapable of observation" — and are in danger of losing 
temporarily the lovelier feminine qualities. And be it 
finally emphasized that what a crowd will do is a very 
different thing, in all likelihood, from what each of the 
individuals in it would do if alone; and that generally 
the crowd's standards of conduct are likely to be lower 
than those of its component elements. 



138 A DOCTOR'S VIEWPOINT 

PSYCHIC RESEARCH 

Such subjects as apparitions, psychism, spiritualism 
and the like have been so much exploited by charlatans 
and pseudo-scientists, with interests so obviously per- 
sonal and selfish, that reasonable men, honestly desirous 
of ascertaining the truth, have generally abandoned this 
field. Professor Hyslop, however, is an honest, earnest 
searcher for the truth, and his latest book, "Enigmas of 
Psychical Research,"* is entitled to scientific considera- 
tion, even though this must be quite adverse to his posi- 
tion. He accuses scientific men, especially "physical" 
or "materialistic" scientists, of purposely and even ma- 
liciously ignoring the work of those engaged in psychic 
research, of a very culpable indifference to supernormal 
or metaphysical phenomena. "Science," he declares, 
"having become accustomed to residual facts within its 
own domain, is loath to admit the existence of facts 
which limit that domain or demand the acceptance of a 
larger than the ordinary material world." Let us in- 
quire how just are these accusations: 

Charles Darwin some thirty years ago, when spirits 
were rather rife in England, was invited to inquire into 
their nature and habits. Though skeptical, he respect- 
fully and attentively considered the subject and got 
Huxley to help him. The latter visited a seance held 
in a private house and reported to Darwin that "the 
performance was so gross an imposture as ever came 
under my notice." Professor Darwin, who was also 
present, declared: "Unless I had seen it I could not 
have believed in the evidence of any one with such per- 
fect good faith as Mr. Y. (the host) being so worthless. 
It has given me a lesson with respect to the worthless- 



* Boston; Herbert B. Turner & Co. 



EDITORIAL EFFUSIONS 139 

ness of evidence which I shall always remember, and, 
besides, will make me very diffident in trusting myself." 
Charles Darwin concluded concerning the medium on 
this occasion who "had the highest credentials": "To 
my mind, an enormous weight of evidence would be 
requisite to make one believe in anything beyond mere 
trickery" ; and again : "The Lord have mercy on us all 
if we have to believe in such rubbish." Tyndall, who 
investigated "spirits" exhaustively, has described his 
many difficulties in conducting a thoroughly scientific 
investigation in the presence of believers or, shall we 
say, gullible people. He could not persuade them to 
employ such ordinary precautions as are essential to 
investigate these phenomena; and he clearly demon- 
strated their fraudulent character. Prof. Simon New- 
comb, who was perfectly willing to oblige the spiritists 
and to study the phenomena which interested them, has 
left in his "Reminiscences" diverting accounts of how 
he found it impossible to continue on the farcical lines 
laid down by them. Faraday, at the cost of much time 
and trouble, convinced all who were open to conviction 
that fraud and self-deception were at the bottom of 
most of the spiritist doings with which he came in con- 
tact. He was shocked at "the superstitions which in 
this day of boasted progress are a disgrace to the age 
and which afford astonishing proofs of the vast flood of 
ignorance overflowing and desolating the highest 
places." 

If these great names do not suffice Professor Hyslop 
we would add that Podmore, who was president of the 
Psychic Research Society, demonstrated in his book, 
"Studies in Psychic Research," the preposterous and 
flimsy basis for most of the "established facts" on 
which spiritism was founded. This book, by the way, 



140 A DOCTOR'S VIEWPOINT 

is a splended exposition of the laws of evidence which 
should obtain in any investigation, and is well worth 
the perusal of both physicians and lawyers. Jastrow, 
in his "Fact and Fable in Psychology," submits some 
very illuminating data. Balfour, the recent British 
premier, as the result of an exhaustive study of psychic 
phenomena, has become the most conspicuous modern 
example of the "philosophic doubter." Among the great 
men in science who have taken up this subject was Wal- 
lace, who has been characterized as a "willing believer" ; 
this should not surprise any one who has noted how 
"easy" Wallace was in the hands of the anti-vaccina- 
tionists. 

Professor Hyslop does not help his position by such 
characterizations as "physical" or "materialistic" scien- 
tists. Herbert Spencer, the great formulator of the 
doctrine of evolution, was justly impatient of those who 
held that doctrine to be purely materialistic. His 
"First Principles" begin with an earnest and reverent 
consideration of the immaterial "unknowable," whence 
is derived so much of the knowable as finite human wis- 
dom can by patience and reason come to understand. 
Science is knowing; and the real scientist is eager only 
for the truth, no matter where he may find it or whither 
it may lead him. Each worker gathers what he can 
within his own ken, insisting only that his facts shall be 
true and absolutely incontrovertible; and all which he 
gathers together he gladly adds to the sum of all science 
or knowing, which is philosophy, in the hope that his 
gleaning may redound to the welfare and happiness of 
his kind. 

FACTORS OF SAFETY 

"The half of his strength he put not forth." In 



EDITORIAL EFFUSIONS 141 

most great men we discern a conserved energy far be- 
yond the measure of their deeds. All men and women 
have a latent potency ; the resources of mimd and body 
they are able to draw on for supreme occasions are far 
beyond any idea they have had of their capabilities. 
When that profound though untutored psychologist 
Napoleon had got his exhausted army nearly to the 
Alpine summits, and when not another step seemed 
possible, he called a halt for a brief space; and then, 
giving a band a picturesque position, he had "The Mar- 
seillaise" played. The strains reverberating over the 
snows and echoing from the crags moved his men mag- 
nificently across the peaks, by means of the strength 
they had but knew not of. The mortality from wounds 
in a defeated army far exceeds that in the army which 
has triumphed over it. In a recent Harvard-Yale boat 
race, it was not the winners, but the Yale crew, that 
were painfully spent at the end, though you would 
have thought Harvard would be the more exhausted; 
since she had to make the greater effort to win. It was 
the same in the Cambridge-Oxford match a year ago. 
The reason for all this lies largely in that the reserve 
forces in our physical makeup — upon which our mental 
processes are conditioned — are wonderfully ample ; 
wherefore we are able to preserve a fairly normal con- 
dition despite the many inimical agencies environing 
us — undue stresses and strains, accidents, the attacks 
of parasitic organisms, various diseases, and the like; 
and can, most of us, keep going fairly well, through 
to the normal span of human life. For many of our 
functions, the mechanisms are doubled and even trebled ; 
the function of one organ is oftentimes assisted by other 
organs. Our tissues have a property peculiar only to 
living things — that of seff-repair. Only recently it was 



142 A DOCTOR'S VIEWPOINT 

demonstrated in the Laennac Hospital in Paris that 
one may live with lungs reduced by operation to one- 
sixth their usual capacity; many a consumptive goes 
about with no more than that. From one-half to three- 
fourths the liver may be removed without jeopardy 
to life, hardly indeed to health. Many organs are 
bilateral; one really needs but half of them. One-half 
the brain would do — and has had to — after accidents 
or certain diseases. People have got along as if noth- 
ing had happened after the removal of a whole kidney. 
Dr. Samuel J. Meltzer, in a superb lecture on "The 
Factors of Safety in Animal Structure and Animal 
Economy," probably first showed in a scientific way 
how our bodies are provided with large margins of 
safety, over and above the maximum required by nor- 
mal activity; how thus are promoted the integrity of 
life, the perpetuation of species, and the processes of 
natural selection. He borrowed the term from the 
mechanical engineer who, in unwitting imitation of 
nature, calculates that the engines, bridges, and other 
structures he builds should be capable of withstanding 
not only the stresses of reasonably expected maximum 
loads, but also those of six or seven times such loads. 

KILLING AND CONSERVATION 

In modern warfare the cost of killing one soldier aver- 
ages $15,000. In the Boer "row" this item came as 
high as $40,000. The Balkan conflict with Turkey was 
conducted more economically; and yet $10,000 was 
burned up in making one man food for powder — really 
a scandalously profitless business, considering that 
the outlay was a dead loss (nothing funny intended) 
except in fertilizer product. The most expensive 
thing in nature is the destruction of human life; the 



EDITORIAL EFFUSIONS 143 

proceeding would be outrageously costly for the world 
if not a dollar was sunk in it. At $15,000 the head no 
one has any right to claim humankind to have more 
sense than the most dunderheaded creature in the cos- 
mos. The Balkans have thrown a scare into Europe 
that is evaporating two billion dollars ; for such is what 
the six great European powers composing the Triple 
Alliance and the Triple Entente are paying for military 
preparations — not for war, but to prepare for war. 
Add to this money waste the loss of production by 
two and a half million young men being withheld from 
the world's real work, for military and naval service; 
and the total cost (at the individual rate of $400 an- 
nually) of the fighting forces of Europe would reach 
the three billion mark. All this is on the highly ra- 
tional theory that the more crushing and blood-sweat- 
ing the war taxes levied on the toiling masses, the less 
likelihood of international slaughter there will be ! It 
makes one recall Heine's terribly grim and unholy apos- 
trophe to the Almighty; "Oh, Thou magnificent Aris- 
tophanes of the universe, how your sides must shake 
with laughter whilst you look down upon us mortals 
and contemplate the epic idiocies of which we are capa- 
ble." (Or words to that effect.) The paradox has 
been well put that the most precious thing in life is 
the cheapest (in dollars and cents), whilst the most use- 
less thing is the dearest, in money. And what is there 
cheaper than life conservation — which is, by the way, 
the biggest idea the twentieth century has thus far 
evolved. Panama, for example, was a generation ago 
about the most pestiferous and gangrenous spot on the 
globe. Colonel Gorgas and his associates have turned 
that region into a veritable health resort; only two or 
three communities in these United States can to-day 



144 A DOCTOR'S VIEWPOINT 

get under the Canal Zone death rate; and the actual 
cost of this job has been $2.43 the individual. The 
Rockefeller Commission for the Eradication of Hook- 
worm Disease and its humane allies are curing many 
thousands of the people in our southland at some- 
thing under seventy-eight cents the head. Which is 
the nobler achievement; such a life-saving one; or 
that other $15,000 the man life-destroying proposition? 
Nowadays, on this side of the Pond at any rate, a 
great many people are seeing the point; for example, 
these citizens who are in the Life Insurance business. 
Actuaries are estimating that $1,500,000,000 is a safe 
estimate of the economic value of lives that are lost 
needlessly each year in the United States alone, not 
through wars, but only through preventable sickness 
and accidents. The idea of health conservation was 
Professor Irving Fisher's of Yale. He several years 
ago outlined a plan for the education of the public 
to the end that Federal, State and municipal authori- 
ties might provide improved health protection; and he 
suggested that life insurance companies, purely in the 
way of business, and of "enlightened selfishness," could 
well afford to contribute in money and brains to such 
a campaign. Well, the Association of Life Insurance 
Presidents, representing policy holders all over the 
world (some twenty millions in the United States alone) 
are working the suggestion for all it is worth. They 
are educating their clients, and urging them by every 
means in their power, for personal and communal hy- 
giene and for disease prevention. And the movement 
is permeating every phase of our civilization. 

THE ETHICS OF INFECTION 

A hitherto unknown race of men — "white Eskimos" 



EDITORIAL EFFUSIONS 145 

— has been discovered by Dr. Vilhjalmur Stefansson in 
the Coronation Gulf territory of Victoria Land, British 
Columbia. Several fanciful theories of their origin 
have been offered; Dr. Stefansson's own theory is that 
this new race consists of descendants of a Norse colony 
in Greenland, supposed to have been totally destroyed 
by hostile Eskimos long ago. A remnant, according to 
Dr. Stefansson's hypothesis, escaped westward and 
mingled with the Eskimos of Victoria Land. The 
characteristics of the new race differ from those of any 
hitherto known people of the Arctic regions and the 
occasional appearance among them of blue eyes and light 
hair renders the theory of Scandinavian descent prob- 
able. The moral status of the new race is said to be 
high. 

According to newspaper report Dr. Stefansson says : 
"Whenever a new people is discovered, commercial inter- 
ests want to know if any money is to be made and what 
are the mining and fur-trading possibilities. A few 
people want to know what the prospects are for saving 
souls. Nobody seems to take any thought about saving 
bodies." Missionaries, actuated of course by the loftiest 
motives, with much sacrifice, will bring the new people 
knowledge of religion; and traders of all sorts, with 
motives not so conspicuously altruistic, will bring them 
gunpowder and alcohol, and both missionaries and 
traders will bring them new and deadly infections. If 
history repeats itself, the result will very likely be the 
extinction of this really fine people by disease and alco- 
holism, aided perhaps by famine following on the ex- 
termination of the caribou by firearms. The history 
of exploration and conquest is full of parallel instances. 

John Guille Millais,f the son of the great painter, 
tMillais, J. G. : Newfoundland and its Untrodden Way. 



146 A DOCTOR'S VIEWPOINT 

says of the Newfoundland Micmacs, that "consumption 
and the traders' rum are playing havoc with this fine 
race." Dr. Grenfell has observed that epidemic diseases 
have up to recent years been practically unknown along 
the Labrador coast. The infections which the natives 
have contracted have been introduced mostly from 
regions to the south. One little Labrador settlement 
was for the first time visited by typhoid fever ; Grenfell, 
when he arrived on his healing mission, found eighty 
frozen bodies of those who had speedily and most miser- 
ably succumbed to it. Tuberculosis, diphtheria and the 
exanthems are much more fatal among the Labradoreans 
than among us. 

Dana wrote in 1835 J : "It has been said that the 
greatest curse to each of the South Sea Islands was the 
first man who discovered it; and every one who knows 
anything about the history of our commerce in those 
parts knows how much truth there is in this ; and that 
the white men, with their vices, have brought in diseases 
before unknown to the islanders, which are now sweep- 
ing off the native population of the Sandwich Islands at 
the rate of one-fortieth of the entire population annual- 
ly. The curse of a people calling themselves Christians 
seems to follow them everywhere." 

Measles is an exanthem comparatively innocuous in 
civilization, but deadly to primitive peoples unaccus- 
tomed to it. Dr. Stefansson says that it has killed 50 
per cent, of the Eskimos in Canada and Alaska in the 
last fifty years. It was entirely unknown in the Fiji 
Islands until introduced by whites in 1875. Thereupon 
in a single epidemic 40,000 of 150,000 Fijians, men, 
women and children, the aged and the young alike, died 



IDana, R. H., Jr. : Two Tears Before the Mast. 



EDITORIAL EFFUSIONS 147 

most pitiably of measles. How often, since the Span- 
iards following Columbus came in touch with the Carib- 
beans (whose name alone is left) has benevolent assimi- 
lation spelled pitiless extermination! The negro in 
his native Ethiopia knew nothing of consumption, syph- 
ilis, alcoholism or cocainism until his white brother 
came to bestow on him the blessings of civilization. 
Now tuberculosis is proving fatal to large numbers of 
the negro race in these United States. The same dreary 
story obtains regarding the American Indian whenever 
and wherever our people have come among them, with 
our tubercle bacillus and our fire-water ; for the Indian 
is dying of tuberculosis in greater numbers than the 
negro and in far greater numbers than the whites. 

Thus racial susceptibility to bacterial disease should 
give pause to those who contemplate the "regeneration" 
of peoples too gratuitously assumed to be barbarian and 
inferior, and whose departures from civilized standards 
are conditioned largely by environment. The "perpet- 
ual quarantine" urged by Dr. Stefansson for the white 
Eskimos seems reasonable and humane. He says : "The 
only really intelligent management of the Eskimo in 
the world is in Greenland. Here Denmark has a per- 
petual quarantine, and as a result the population is on 
the increase. Nobody is allowed to land in Greenland 
unless he is thoroughly inspected. Such an arrange- 
ment is perfectly feasible for the protection of the 
Coronation Gulf Eskimos." 

CONSUMPTION AND CIVILIZATION 

The tubercle bacillus is an index by inversion of the 
real progress of the race. By it the claim of civiliza- 
tion to dominate human life may fairly be judged. 
Tuberculosis will decrease with the substantial advance 



148 A DOCTOR'S VIEWPOINT 

of civilization, and this disease will as surely increase 
as civilization retrogrades. Is this statement much too 
broad? Is it untenable? Consider, then: 

There is no phase of life which tuberculosis does not 
touch — nay, upon which it does not press with a most 
grievous, heavy hand. It claims, between infancy and 
old age, every seventh, and between adolescence and 
maturity every third or fourth, life — in some of our 
communities every other life. Every other adult negro 
succumbs to it. 

Society's "submerged strata," which cannot free 
themselves from the grip of pestilent environment — 
the darkness, wretchedness, and starvation upon which 
the saprophytic bacillus propagates its teeming bil- 
lions — yield victims far in excess of those claimed by all 
other infections put together. 

Nor are the rich, in fancied security, any freer from 
the danger than were the gallants and the gentle ladies 
in Poe's dreadful tale, who thought by isolating them- 
selves to escape the Black Death. For the beautiful 
laces and garments worn by the well-to-do and the 
pretty things worn by their children, and often got at 
remarkably low prices (for is he not a fool who does 
not buy a thing as cheaply as he can?) are like as 
not worked at and bent over and coughed upon from 
dawn until midnight by sweat-shop consumptives. Thus 
much oftener than we imagine does the poverty of 
Lazarus make itself felt in the house of Dives. 

There is scarcely a trade, or occupation, or business, 
or calling which does not, in varying degree, give up 
its quota of valuable lives. And the factory is even 
more productive of tuberculosis than the home for the 
consumptive workman, under conditions which have up 



EDITORIAL EFFUSIONS 149 

especially stigmatized and "resoluted" against as being 
"the principal theater of vivisection operations in this 
part of the world to-day." A bill was read, which had 
been introduced in the legislature at Albany; and the 
assemblyman who was responsible for it naively ob- 
served that in passing it the state would incur no ex- 
pense, for the Antivivisection Society and the Humane 
Society had offered to provide the salaries of the in- 
spectors proposed in the bill. 

The second act of this play takes place in the city 
of New Brunswick, N. J., where the two villains of the 
cast, by name Dr. H. H. Janeway and Dr. E. I. Cronk, 
have been laboring under the obsession that without 
animal experimentation medicine would be "but a sav- 
age art — not even the shadow of the present science 
of cure and prevention." Being desirous of perfecting 
an operative procedure for gastric cancer and tuber- 
culosis, they have done tentative operations on animals ; 
and have also, in a spirit equally unscientific and cal- 
loused, removed a lobe of one lung from a dog named 
Pete. The sufferings which a veracious lady of that 
city had alleged this dog was enduring have divided that 
generally peaceful and sane community into two camps. 
A somewhat Gilbertian warfare has resulted; most of 
the contestants, especially the feminine participants, 
"did not know what it was all about anyway." A 
superb strategic move was the arrest of Drs. Janeway 
and Cronk on charges of cruel usage of the dog Pete, 
made by the aforesaid tender-hearted lady; the mis- 
creants happily regained freedom when bail of $300 for 
each was paid. Pete, because of whose agonies the 
arrests were made, was sought for in his usual com- 
fortable bunk in Dr. Janeway's barn. But the martyr, 
who "for the sake of science, had given most of him- 



150 A DOCTOR'S VIEWPOINT 

self away," was absent; he (or what remained of him) 
was found near by, engaged, with all his old-time zeal, 
in his favorite occupation of chasing the New Bruns- 
wick cat; which he, in his turn, was trying to vivisect. 

The third act takes place on a bleak bank of the East 
River, with the reprehended Rockefeller Institute pro- 
viding the back scene. Several hours before dawn a 
venerable gentleman rang the bell at the entrance door 
of the building. But there was no one to respond to 
his ringing. He therefore sat down before the doorstep, 
or waited about it in most inclement weather, until 
daylight. Being then admitted, he made known his 
errand. He is connected with Berea College, where 
either a real or suspected case of epidemic cerebro- 
spinal meningitis has developed; and he was most anx- 
ious to secure some of the serum which Dr. Flexner 
and his associates have, largely through animal experi- 
mentation, evolved both for curative and prophylactic 
purposes, against that dreadful disease. At first it was 
thought to refuse his request, for the reason that the 
work on this serum is still in the experimental stage. 
Finally, however, on his assurance that it would be 
given only by skilled physicians, who would be respon- 
sible for its proper use, several vials of this serum were 
entrusted to him; and they were at once rushed off to 
Kentucky, in the hope that they would reach their des- 
tination within twenty-four hours. All men and women 
of really humanitarian instincts may reasonably enter- 
tain the belief that in this circumstance valuable human 
lives have thus been saved, and that much of the ghast- 
liest sufferings in all medical experience has thus been 
averted. 

The reader must decide for himslf if this play has 
been a farce, a comedy, a drama or a tragedy. 



EDITORIAL EFFUSIONS 15U 

MONGRELIZED RACES 

Dr. Eliot, of Harvard, spoke recently of the changes 
immigration has wrought in the industrials, family life, 
and civilization generally of Massachusetts ; he fears 
a great political evil in the lack of homogeneity now 
obtaining in that population. Not in a century may 
it become homogeneous if ever at all. 

In his youth his community was homogeneous. His 
father's servants, the men who worked the farm, the 
mechanics and all the servants at Harvard, were Amer- 
icans, descended from pilgrim stock — all except a de- 
cent Irishman who worked about Cambridge. Marvel- 
ous; only one Celt to a whole American community. 
Tempora mutantur. The puzzle to-day would be to 
find a single puritan in a Hibernized (though far from 
hibernating) community. Dr. Eliot emphasized that 
there was in his boyhood but one racial element and 
seems to deplore our present-day mixture. Yet we may, 
like honest Touchstone, thank the gods for our race 
mixtures, trusting that homogeneity may come here- 
after. The point to emphasize is that those superb 
puritans of Dr. Eliot's youth were themselves not at 
all pure — that is, ethnically. There has never been 
since Homer, nor probably many thousands of years 
before the blind bard, a pure race; and providential it 
is that this has been so. 

The English who supplanted the aboriginal Indians 
were by no means a pure type; nor were the Dutch 
themselves in all probability not a pure race, nor the 
French nor the Spaniards. Take the Frenchman of 
to-day. In the North are the descendants of the Belgae, 
the Walloons and other Kymri; in the East those of 
Germans and Burgundians; in the West Normans; ir 



152 A DOCTOR'S VIEWPOINT 

to recently prevailed, has infected his fellow-workman 
more than he has the members of his own family. 

In literature and the arts how many precious lives 
have succumbed to this veritable captain of the men 
of death. Consumption has ever been "death's direct 
door to most hard students, divines, physicians, phil- 
osophers, deep lovers, zealots in religion." Who can 
estimate the loss in beauty, poesy, in intellectual treas- 
ures, and in all the sweetnesses^ and refinements of life, 
which this disease has inflicted upon us? How many 
an inspired genius, even before his powers have matured, 
has suffered its most untimely visitation! 

The proverb goes, "Trokner Husten-Toder Trom- 
peter"; nor has the sword ever been nearly as voracious 
of human life as has been the tubercle bacillus. And 
such scourges as cholera, the plague, small-pox, al- 
though they have been more gruesomely picturesque in 
their ravages, have never been in the running with 
consumption. 

An intensely practical spirit has come to be repre- 
sentative of our present-day civilization, and of this 
we are exceedingly vain. In the popular phrase, every- 
thing is centered in the question: "Does it pay?" and 
whatever fails to come up to the price of money stand- 
ard is eschewed contemptuously. ^ To understand ade- 
quately this tendency one has but to contemplate, for 
so long as he can endure to look upon it, the charac- 
terization of Mammon which Mr. Watts has painted. 
It is, then, nothing short of astounding — the economic 
losses which we permit tuberculosis to inflict upon us ; 
astounding how our shrewdness, our business prescience, 
has in truth a mission machine no farther than the 
essentially obtuse angle the apex of which is the end 
of its nose. 



EDITORIAL EFFUSIONS 153 

Tuberculosis is a disease entirely preventable — and 
by means extraordinarily ample, and of comparatively 
little cost. Yet, to state a single fact, it is costing 
the United States an annual loss exceeding a billion of 
dollars. Thus, then, does this disease affect most in- 
timately every relation in life, every aspect of civiliza- 
tion — the infant subsisting on impure milk; the child 
studying in unhygienic schools ; the adolescent con- 
tending with the conditions peculiar to those years; 
young men and young women aspiring to matrimony; 
the mother, in whom lies the destinies of the races ; the 
man who should be sturdily accomplishing the world's 
work. Tuberculosis is pervasively concerned with our 
habits and customs, with our housing conditions, the 
sanitation of our cities, the regulation of child labor, 
and innumerable other details of existence. It has to 
do fundamentally with human evolution; with human 
heredity, its preservation, its course in the present life, 
its generations to come. It provides a subject much 
more worthy wise and sane legislative consideration 
"than all the many questions that make and unmake 
Ministries." From whatsoever point one views this 
all-permeating matter, one must conclude that tuber- 
culosis is indeed the executioner which fulfils the law 
of the survival of the fittest. 

AN ANTIVIVISECTION PLAY, IN THREE ACTS 

The scene of the first act is laid in Carnegie Lyceum, 
in New York City, where there was recently an en- 
thusiastic gathering. Dinners, of which roasted or 
broiled meats (animals, by the way, almost invariably 
meet tragic deaths) were a part, were being comfortably 
digested ; so that everybody was in a position to take 



154 A DOCTOR'S VIEWPOINT 

an amiable interest in the proceedings. The great ma- 
jority in this audience were women, who wore the plumes 
of slaughtered birds in their hats; and (it being even- 
ing) pet dogs, whose tails had been docked, and whose 
ears had been clipped, were reposing undisturbed at 
home. The lady president of the Antivivisection So- 
ciety (in alliance with the International Antivaccina- 
tion Union) spoke with the precision of statement so 
characteristic of the feminine mind. The great diffi- 
culty in getting started in this country, she declared, 
is because, "while no doubt 50 per cent, of the medical 
profession are to-day at heart opposed to vivisection, 
its leaders in New York, confident in their eminence and 
power to punish, have sent out a practical prohibition 
to all physicians that they should not approve or sus- 
tain in any manner any movement toward a restriction 
of vivisection." Several public-spirited gentlemen were 
on the platform. One among these, in terms conspic- 
uous for man-like temperance of expression, stated that 
those medical experimenters who vivisected animals 
were "virtuosos of agony, in whom curiosity, vanity or 
scientific zeal has supplanted humanity, and to whom 
harmonies or discords of agony or long-drawn cadences 
of torture, struck from quivering nerves are music." 
One clergyman contended that the practices condemned 
are continued for "the purposes of commercialism, 
to obtain antitoxins, which have not yet proved their 
effiacy, and in some instances have been known to have 
increased disease instead of decreasing it." Another 
maintained that vivisection is "contrary primarily to 
the law of God ;" this clergyman would no doubt a gen- 
eration ago have denounced the administration of 
chloroform to women in labor, on the basis of some 
scriptural expression. The Rockefeller Institute was 



EDITORIAL EFFUSIONS 155 

the centre Celts, who at the same epoch when their 
name took its origin consisted of foreigners of various 
ancestry and of the aborigines; in the South were 
ancient Aquitanians and Basques: without mention- 
ing a host of settlers like the Saracens ; the Tectasages, 
who have kept at Toulouse the custom of cranial de- 
formities; and the traders who passed through the 
Phocaean town of Marseilles. 

Professor Boas, of Columbia, has found that when 
the ratio of race intermingling is as one to nine, there 
will be among the more numerous population only 18 
to 1,000 in the fourth generation that will be of pure 
blood; and where two types intermarry with equal 
freedom, less than one person in 10,000 in the fourth 
generation will be of pure descent; that is, within 
a century the process of intermixture in this nation 
should be complete — homogeneity achieved! 

A mixed race become homogeneous is as nearly per- 
fect as a human race can be; and the more elements 
that enter the mixture the nearer will the ideal be 
approached. Is the reader not convinced? Look, 
then, on one of the recent pictorial pages of the Sunday 
Times. One sees here the photographs of the adorable 
"snow baby," taken during her first summer in Green- 
land ; and so through the various eras of her existence 
to the culminating portrait of Miss Marie Ahnighito 
Peary. Here is a triumph of natural eugenics that has 
delighted the eye of every young fellow — and of cer- 
tainly one old fellow — that has had the good fortune to 
contemplate it. At least four races have been the 
blessed heredity of this most winsome gentlewoman; 
for her father, Admiral Peary, is of English and French 
descent ; and her mother is of German and Russian for- 
bears. 



156 A DOCTOR'S VIEWPOINT 



SPUGS AND SPEFS 



It is a fine thing to be a spug — a member of the 
Society for the Prevention of Useless Giving ; this is an 
excellently purposed and was recently a very active 
institution. Why not organize now a spef and begin 
without delay a membership canvass. The spef will 
not have so many calls for action made upon him; 
but for all that he need not necessarily be a dead one. 
He certainly will have for his consideration either a 
grave subject or a burning question, according to the 
position he takes. The wily writer, having now worked 
the principle of suspense for all it is worth, explains 
spef to mean a Society for the Prevention of Exor- 
bitant Funerals. At first it occurred to propose spuf, 
a Society for the Prevention of Useless Funerals. But 
then not all funerals are useless — some are, on the con- 
trary, very well worth while. Instances in point will 
spring at once to mind; for every reader has his own 
little list. One of the first things to come up for the 
society's consideration would be, which is preferable, 
burial or cremation? Both are not necessary, although 
a Chicago lady, whose husband died in New York, is 
reported to have deemed them so ; for when the under- 
taker (this joke is at least as old as Chicago) tele- 
graphed her whether he should cremate or bury, she 
instantly wired back, "cremate and bury, take no 
chances. 5 ' 

But very seriously, the enormous amounts which many 
among the poor pay for the funerals of their dead, have 
become a grievous matter. In a most pathetically 
squalid tenement apartment one will see an expensive 
coffin, many flowers, elaborate funeral furnishings, an 
all too ostentatious array of carriages, the neighbor- 



EDITORIAL EFFUSIONS 157 

hood crowding about and peering from the windows 
of many houses, and oftentimes a band of musicians 
heading the mourning procession to an expensive plot. 
Here is, indeed, a situation almost grotesque and Ho- 
garthian, and certainly demanding reformation. In 
this relation one may well contrast burial with cre- 
mation. The latter need offend no religious sense, may 
indeed tend to a loftier religious exaltation; many 
of the clergy have spoken in favor of it. Were it not 
indeed the nobler conception — that of the spirit of the 
dead arising to the heavens out of the ashes of the 
body, than that the latter should remain to decay in 
ways most repugnant to the imagination. And is not 
cremation more than burial in consonance with the 
beautiful Pauline sentiment we have all heard under 
circumstances the mdst solemn in human experience, 
that "there is a natural body and there is a spiritual 
body"? Nor is cremation any longer a method on 
trial; it is established in many places throughout civ- 
ilization. The point here to be made, however, is dem- 
onstrated in the experience of the Cremation Society 
of England, which was founded in 1874; in the hope 
of interesting the poor (who there, as among us, often- 
times spend far more than a right proportion of their 
means on funerals) this society made its fee $25 — a 
um several times cheaper than the cost of burial. How- 
ever, this poetic manner of disposing of the beloved 
dead has thus far found favor in England least among 
the poor, and chiefly among the professional, the in- 
tellectual, and the well-to-do. 

EUTHANASIA 

Maeterlinck, in his book "Death," declares that all 
our knowledge but helps us to die in greater pain than 



158 A DOCTOR'S VIEWPOINT 

the animal that knows nothing. As science progresses 
it but makes for a prolongation of the agony of death 
— the most dreadful and the sharpest peak of human 
pain and horror, at least for the witnesses. "All the 
doctors consider it their first duty to protract as long 
as possible even the most excruciating convulsions. 
Who has not, at a bedside, twenty times wished to 
throw himself at their feet and implore them to show 
mercy." The prejudice against the arbitrary induction 
of a painless and premature death will one day, believes 
the Belgian Shakespeare, be regarded as barbarian, as 
a "relic of the times when humanity was convinced that 
any known torture was preferable to those awaiting 
us in the unknown"; and he predicts that a day will 
come when science will no longer hesitate to shorten 
our misfortunes. "When life, grown wiser, will depart 
silently to its hour, knowing that it has reached its 
term, even as it withdraws every evening while we sleep, 
knowing that its day's task is done." 

One hesitates to reopen this question whether phy- 
sicians should purposely hasten the deaths of sufferers 
from painful diseases, or of those patients who would 
seem beyond recovery, and had therefore best be dead 
— a question which physicians must ever answer by a 
decided negative. But the views of a man of Maeter- 
linck's caliber cannot be slighted. And the wonderful 
skill and literary charm he evinces fascinate the reader, 
and give weight to opinions which might be ignored 
were they less beautifully and touchingly expressed. 
Yet, the author of "Pelleas et Celisande" is a mystic, 
a poet and a dreamer of exquisite dreams — such a 
one the like of whom the world is ever in need of, and 
perhaps never more so than to-day. On the other hand 
it is essential for science — certainly for medical sci- 



EDITORIAL EFFUSIONS 159 

ence — to deal ever with the hard facts of life; should 
science seek to evade its responsibilities in these prem- 
ises, she would swiftly be brought to book — in the 
criminal courts, for example. For it is not given to 
science to appoint herself, upon her own initiative, an 
executioner of human beings. Among the hard facts 
which science has to face are the following (which have 
to be reiterated in every opening of the euthanasia dis- 
cussion) : Physicians can never be sure that their 
prognoses of a fatal issue are absolutely mfallible. 
People that have suffered from seemingly irremediable 
cancer, or from chronic tubercuolsis, have attended 
the funerals of the doctors who have ministered to them 
in their "fatal" illnesses. To err in medical prognosis 
is human ; only divinity can appoint unerringly the hour 
of death. Nor has the physician (nor any other mor- 
tal) any right to hasten a death upon his human as- 
sumption of its inevitableness. Again, what a weed- 
choked field of possibilities, criminal or otherwise, would 
be sown were such advocacy as this of Maeterlinck to 
prevail ; were, for example, the physician overpersuaded 
by the specious pleas of heirs, or by the simulated pity 
of other individuals anxious to sever ties such as most 
of mankind find precious, to provide for the sufferer, 
before his appointed time "a gentle and easy death." 
These quotations from the writing of a most de- 
serving Nobel prize winner "for literature" make 
"copy" interesting indeed ; yet it is to be feared they do 
not accurately express the situation. Physicians are not 
hardened men; there are none, as a class, more sym- 
pathetic. The span of doctors' lives averages shorter 
than in most other callings — and this probably because 
the sufferings of their fellow mortals take so much out 
of them. It is not essential to medical practice to 



160 A DOCTOR'S VIEWPOINT 

prolong any convulsions ; and there would never be the 
slightest occasion for anyone, on bended knee, to im- 
plore the physician to alleviate sufferings. To relieve 
pain is a first principle in practice, and the physician 
is always justified in this course, in so far at least as 
the life of the patient will not be jeopardized by his 
ministrations. And the physician is ever eager to do 
this, if for no other reason than that there is hardly 
anything so killing as pain. As to the horror of death, 
this the spectators may have; but it is the rarest 
phenomenon for him who is about to die to "suffer" 
death. Immediately death impends, the end is almost 
invariably benignant and beautiful. What, indeed, is 
there in all the cosmos so composed and content as 
the face of the dead? 

THE PHILOSOPHY OF PBAYER 

Part of a recent sermon by a veritable man of God 
is thus reproduced: In studying the biography of 
any great man we are very likely to be impressed with 
the paucity of his deeds and sayings by comparison 
with the influence he has exerted upon his day and 
generation ; we cannot, by a consideration of the former, 
reach any just estimate of that influence. In such 
study we eventually become impressed, not so much 
by what the great man in the given instance did, or what 
he said, but by what he was — his character. This is so 
of Washington, of Julius Caesar, of Abraham Lincoln, 
of Richard Wagner, and many another. All men, great 
and small, do and say for the most part what their en- 
vironment, what the conditions of their time, require of 
them; but if we are to discern the intrinsic secrets of 
the power they have wielded, we must study not so 
much their word and deeds, as their personal habits. 



EDITORIAL EFFUSIONS 161 

Jesus Christ preached and healed the sick with alto- 
gether peculiar power; but it is probable that His 
tremendous influence upon mankind since His advent 
has been mainly by reason of His character. And 
to understand this we must study His personal habits. 
Conspicuous among these was that of prayer. Again 
and again, being sought in the intervals of His be- 
nign ministrations, His disciples found Him in prayer. 
In all my own ministry I have experienced nothing so 
fatiguing as an afternoon spent in sick calls ; I confess 
this leaves me utterly exhausted, and only in prayer 
can I find refreshment of body and soul thereafter. I 
cannot sufficiently extol medical men, who are with 
the sick all day long, every day, and half way into 
the night. I wonder how they can do so ; I marvel how 
they can endure the strain! The Archbishop of Salis- 
bury, in a talk with medical students, advised them by 
way of relaxation from their duties to cultivate poetry ; 
I know a better pursuit than that; it is to cultivate 
the habit of prayer. 

An episode of hospital service is here recalled. On 
the interne staff was a quiet young man who by reason 
of his religious tendencies was blithely nicknamed 
"Grandma." When a difficult case was to be seen some 
one would say: "Let's have grandma along; any way 
he can help some by chipping in a prayer." In due 
time grandma became a "House"; and late one night 
a woman was jbrought into his ward who must surely 
die, if not at once operated on. Grandma 'phoned 
at once to his Visiting in town, who returned answer 
that he could not come, and that his House must oper- 
ate in his stead. The patient was speedily prepared, 
and, to reinforce the poor gaslight (electric lights had 
not yet been installed in that hospital), other internes 



162 A DOCTOR'S VIEWPOINT 

and helpers stood about holding lanterns. In such 
Rembrantesque surroundings and with perhaps a dozen 
nurses as added spectators, all moved by the gravity of 
the case, Grandma, scalpel in hand, stood by the side 
of his patient, at the operating table. It was a most 
impressive moment when he closed his eyes, his head 
bowed and his lips moving. Thus encouraged and forti- 
fied, he got at once to work; with his hand from first 
to last so sure, his eye so keen, and his brain so clear, 
that he seemed quite transfigured. Thus did grandma 
do a piece of work that many a rising surgeon might 
have envied. And when the last stitch was done, and the 
patient carried to her ward, those fellow-internes saw a 
light — which possibly remained with them till they 
reached their own bedsides. 

The indubitable trend of modern thought is monistic, 
the basic conception being of a cosmic oneness in 
which all phenomena, however diverse they may seem, 
are inter-related and inco-ordinated. It is from this 
viewpoint that we recall three papers, by the late Rev. 
Dr. W. R. Huntington, the late Moueure Conway, D.D., 
and Dr. Lyman Abbott on "The Nature of Prayer." 
The layman as to theology could not fail to have been 
impressed with an idea that suffused all these three 
papers by clergyman each of a different Christian de- 
nomination: that prayer is helpful to the individual 
not as to the granting of specific personal requests; 
not that the inherently benignant laws of nature would 
be disturbed in any personal behalf; but that prayer 
is helpful in bringing him who prays into comfortable, 
restful and solitary relations with that First Cause 
known to human kin as The Almighty, Jehovah, "the 
power not ourselves that makes for righteousness," and 
so on. (May we not presume here to interpret the 



EDITORIAL EFFUSIONS T63 

term righteousness as meaning Tightness, orderliness, 
consistent inter-relation, universal oneness.) It can- 
not but gratify the humanitarian who is not a clergy- 
man to observe this departure from the theology of 
other eras; it is gratifying especially to the medical 
scientist, by reason that this modern aspect of re- 
ligious faith, as here expressed by eminent clergymen, 
is much in unison wits scientific faith — faith in the 
constancy of the universe, in the invariability of its 
laws, and in that infinite and eternal energy which 
permeates the cosmos. One may indeed venture the 
hope that, of the age-long conflict between theology 
and science, which has oftentimes been so cruel, so 
insistent and so deadly, there remains to-day but a 
difference, not at all of ideas, but only of nomenclature. 
May it not be hoped that somewhere between those 
two camps, of metaphysics and of materialism, a single 
standard can be raised to which all devout may alike 
repair — the standard of the universality, the monism 
of all human experience. Could not, then, a philosophy 
of prayer comprehensible to all be evolved — from which 
could ensue a consistent therapeutics of prayer. As- 
suredly the human being needs help from without ; for, 
though a coefficient in the working out of his own 
destiny he is, when unassisted, a pathetically helpless 
atom in the universal scheme. When such "world com- 
pellers" as Bismarck, Gladstone and Cromwell and the 
like have humbly acknowledged this need, surely lesser 
men may seek it as well as they, and without humilia- 
tion. Is it not that the various aspects of human 
nature — the physical, the intellectual, the volitional 
and the emotional — when they have been perturbed 
by the stresses of life, are brought by prayer back to 
their normal co-ordination and functioning; that the 



164 A DOCTOR'S VIEWPOINT 

individual in prayer gets his relations to his environ- 
ment readjusted, and finds himself restored to har- 
mony with the eternal verities. Such, we submit, would 
be a reasonable conception of prayer which might well 
be advised and taught both in the pulpit and the clinic. 



